NPIMap

Organization Active NPI

F O R M E Medical and Rehab Center of Warren Inc

  • Chiropractor
  • Warren, OH
National Provider Identifier
1245390343
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
139 Issued in OH
Legal business name
F O R M E MEDICAL AND REHAB CENTER OF WARREN INC
Practice address
2103 Niles Cortland Rd SE
Warren, OH 44484-3067
Phone
(330) 544-3737
Fax
(330) 544-3904
NPI assigned
Dec 11, 2006
Last updated
Sep 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Authorized official

Name
Nestor A Stychno, D.M., D.C.NPI 1518006626
Title
President
Phone
(330) 544-3737

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2393 OH
Chiropractor 111N00000X 139 OH Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X 35050935 OH

Addresses

Primary practice location

2103 Niles Cortland Rd SE
Warren, OH 44484-3067

Mailing address

2103 Niles Cortland Rd SE
Warren, OH 44484-3067
Phone (330) 544-3737

Other identifiers 3

IdentifierTypeStateIssuer
0119473MedicaidOH
0608444MedicaidOH
2459129MedicaidOH

National Provider Directory

National Provider Directory

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": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1245390343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 NILES CORTLAND RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444843067",
            "telephone_number": "330-544-3737",
            "fax_number": "330-544-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 NILES CORTLAND RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444843067",
            "telephone_number": "330-544-3737",
            "fax_number": "330-544-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "F O R M E MEDICAL AND REHAB CENTER OF WARREN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "STYCHNO",
        "authorized_official_first_name": "NESTOR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-544-3737",
        "authorized_official_credential": "D.M., D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2393",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "139",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OH",
            "license": "35050935",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0119473",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0608444",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2459129",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; 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.