Individual provider Active NPI

David C Black, D.C.

  • Chiropractor
  • Bucyrus, OH
National Provider Identifier
1316007123
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1392 Issued in OH
Practice address
234 S. Sandusky Ave
Bucyrus, OH 44820
Phone
(419) 562-4242
Fax
(419) 562-4979
NPI assigned
Dec 11, 2006
Last updated
Jan 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1392 OH Primary

Addresses

Primary practice location

234 S. Sandusky Ave
Bucyrus, OH 44820

Mailing address

234 S. Sandusky Ave
Bucyrus, OH 44820
Phone (419) 562-4242

Other identifiers 1

IdentifierTypeStateIssuer
0759415MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1392OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Chiropractic and Therapy Center Inc Chiropractor Past Accepting new patients
Affinity Healthworks LLC Past Accepting new patients

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1316007123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 S. SANDUSKY AVE",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "44820",
            "telephone_number": "419-562-4242",
            "fax_number": "419-562-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 S. SANDUSKY AVE",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "44820",
            "telephone_number": "419-562-4242",
            "fax_number": "419-562-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "DAVID",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0759415",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bucyrus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; 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.