Individual provider Active NPI

Daniel E Lara, D.C.

  • Chiropractor
  • Powell, OH
National Provider Identifier
1255571493
Registry record updated Jul 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3966 Issued in OH
Practice address
47 Clairedan Dr
Powell, OH 43065-8064
Phone
(614) 505-8600
Fax
(614) 505-6025
NPI assigned
Feb 28, 2009
Last updated
Jul 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3966 OH Primary

Addresses

Primary practice location

47 Clairedan Dr
Powell, OH 43065-8064

Mailing address

2222 Stringtown Rd
Grove City, OH 43123-2929
Phone (614) 871-2273

Other identifiers 2

IdentifierTypeStateIssuer
H091010OtherOHMEDICARE PTAN
0065298MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120515000293 OH Practitioner - Chiropractic 3779746599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

47 Clairedan Dr
Powell, OH 43065-8064
Phone (614) 505-8600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3966OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Powell Chiropractic & Wellness LLC Chiropractor CurrentSince Jul 1, 2020 Accepting new patients
Women's Health Partners, LLC PastSince Jul 1, 2020 Accepting new patients

Locations

47 Clairedan Dr
Powell, OH 43065
Phone (614) 505-8600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1235779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593907200000",
    "number": "1255571493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 STRINGTOWN RD",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431232929",
            "telephone_number": "614-871-2273",
            "fax_number": "614-871-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 CLAIREDAN DR",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430658064",
            "telephone_number": "614-505-8600",
            "fax_number": "614-505-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "DANIEL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-28",
        "last_updated": "2020-07-05",
        "certification_date": "2020-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H091010",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0065298",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.