Organization Active NPI

Synergy Chiropractic, LLC

  • Sports Physician Chiropractor
  • Medina, OH
National Provider Identifier
1255833117
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
4013 Issued in OH
Legal business name
SYNERGY CHIROPRACTIC, LLC
Practice address
790 Lafayette Rd Ste 1
Medina, OH 44256-2434
Phone
(330) 208-7088
NPI assigned
Mar 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Authorized official

Name
Dr. Christopher Scott Foust, DCNPI 1396937272
Title
Owner
Phone
(330) 208-7088

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
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X 4013 OH Primary

Addresses

Primary practice location

790 Lafayette Rd Ste 1
Medina, OH 44256-2434

Mailing address

790 Lafayette Rd Ste 1
Medina, OH 44256-2434
Phone (330) 208-7088

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181210002648 OH Part B Supplier - Clinic/Group Practice 7012251556 Receives reassigned benefits from 1 practitioner
Practice locations: Medina, OH

National Provider Directory

National Provider Directory

Locations

790 Lafayette Rd
Ste 1
Medina, OH 44256
Phone (330) 208-7088

Practitioners & affiliated clinicians

Practitioners 1

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": "1520294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1255833117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 LAFAYETTE RD STE 1",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562434",
            "telephone_number": "330-208-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 LAFAYETTE RD STE 1",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562434",
            "telephone_number": "330-208-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-06",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "FOUST",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-208-7088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "OH",
            "license": "4013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.