Organization Active NPI

Fully Alive Chiropractic LLC

  • Chiropractor
  • Springboro, OH
National Provider Identifier
1235595075
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4594 Issued in OH
Legal business name
FULLY ALIVE CHIROPRACTIC LLC
Practice address
90 Commercial Way
Springboro, OH 45066-3080
Phone
(937) 748-9708
Fax
(937) 806-4112
NPI assigned
Jan 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Authorized official

Name
Nathan SiebenallerNPI 1528424546
Title
Owner
Phone
(937) 748-9708

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4594 OH Primary

Addresses

Primary practice location

90 Commercial Way
Springboro, OH 45066-3080

Mailing address

90 Commercial Way
Springboro, OH 45066-3080
Phone (937) 748-9708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160411000040 OH Part B Supplier - Clinic/Group Practice 4284932104 Receives reassigned benefits from 3 practitioners
Practice locations: Springboro, OH

National Provider Directory

National Provider Directory

Locations

335 N Main St
Ste 2
Springboro, OH 45066
Phone (937) 748-9708

335 N Main St
Ste 1
Springboro, OH 45066
Phone (937) 748-0940

90 Commercial Way
Springboro, OH 45066
Phone (937) 704-0589

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1452297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780272000000",
    "number": "1235595075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 COMMERCIAL WAY",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450663080",
            "telephone_number": "937-748-9708",
            "fax_number": "937-806-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 COMMERCIAL WAY",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450663080",
            "telephone_number": "937-748-9708",
            "fax_number": "937-806-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLY ALIVE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-09",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A",
        "authorized_official_last_name": "SIEBENALLER",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-748-9708"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springboro, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.