NPIMap

Organization Active NPI

Lucas Flynn DC LLC

Doing business as Baltic Chiropractic Clinic

  • Chiropractor
  • Fairlawn, OH
National Provider Identifier
1225540768
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3513 Issued in OH
Legal business name
LUCAS FLYNN DC LLC
Doing business as
Baltic Chiropractic Clinic
Village Square Chiropractic Center
Practice address
55 Shiawassee Ave Ste 5
Fairlawn, OH 44333-3793
Phone
(330) 836-5000
Fax
(330) 836-5015
NPI assigned
Oct 24, 2017
Last updated
Aug 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lucas Edwin Flynn, DCNPI 1881622009
Title
Owner
Phone
(330) 836-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3513 OH Primary

Addresses

Primary practice location

55 Shiawassee Ave Ste 5
Fairlawn, OH 44333-3793

Mailing address

55 Shiawassee Ave Ste 5
Fairlawn, OH 44333-3700
Phone (330) 836-5000

Other practice location 1

102 E Main Street
Baltic, OH 43804
Phone (330) 897-9011

Other names 2

  • Baltic Chiropractic Clinic Doing business as
  • Village Square Chiropractic Center Doing business as

National Provider Directory

National Provider Directory

Locations

55 Shiawassee Ave
Ste 5
Fairlawn, OH 44333
Phone (330) 836-5000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1225540768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SHIAWASSEE AVE STE 5",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333700",
            "telephone_number": "330-836-5000",
            "fax_number": "330-836-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SHIAWASSEE AVE STE 5",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333793",
            "telephone_number": "330-836-5000",
            "fax_number": "330-836-5015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 E Main Street",
            "address_purpose": "LOCATION",
            "city": "Baltic",
            "state": "OH",
            "postal_code": "43804",
            "country_code": "US",
            "telephone_number": "330-897-9011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUCAS FLYNN DC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-24",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-836-5000",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baltic Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Village Square Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Village Square Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.