Lake County Chiropractic Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1153 Issued in OH

Legal business name

LAKE COUNTY CHIROPRACTIC INC

Practice address

1501 Mentor Ave
Painesville TWP, OH 44077-1702

Phone

(440) 352-3500

Fax

(440) 352-3512

NPI assigned

Sep 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Beth Ann Moon, DC

Title

Owner President

Phone

(440) 352-3500

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Beth Ann Moon Other name

Locations

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285737304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MENTOR AVE",
            "city": "PAINESVILLE TWP",
            "state": "OH",
            "postal_code": "440771702",
            "telephone_number": "440-352-3500",
            "fax_number": "440-352-3512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MENTOR AVE",
            "city": "PAINESVILLE TWP",
            "state": "OH",
            "postal_code": "440771702",
            "telephone_number": "440-352-3500",
            "fax_number": "440-352-3512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTY CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "440-352-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL",
            "identifier": "281689990002",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23797",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000179338",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beth Ann Moon",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amanda Barbur, AU.D.

• Chiropractor in Painesville TWP, OH
• Providers in Painesville TWP, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.