Individual provider Active NPI

Beau Shannon Lawyer, D.C.

  • Chiropractor
  • Columbus, OH
National Provider Identifier
1336182138
Registry record updated Sep 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1915 Issued in OH
Practice address
1400 W 5TH Ave
Columbus, OH 43212-2901
Phone
(614) 486-6755
Fax
(614) 486-6781
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1915 OH Primary

Addresses

Primary practice location

1400 W 5TH Ave
Columbus, OH 43212-2901

Mailing address

910 Neil Ave
Columbus, OH 43215-1333

Other identifiers 1

IdentifierTypeStateIssuer
0914381MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120313000724 OH Practitioner - Chiropractic 6305739764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-Village Chiropractic IncGroup PAC ID 8325164569, 2 clinicians

Practice addresses (Care Compare)

1400 W 5TH Ave
Columbus, OH 43212-2901
Phone (614) 486-6755

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1915OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Village Chiropractic, Inc Chiropractor CurrentSince Feb 1, 2014 Accepting new patients
Lawyer Chiropractic Clinic Inc Chiropractor Past Accepting new patients

Locations

1400 W 5th Ave
Columbus, OH 43212
Phone (614) 486-6755

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1336182138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 NEIL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W 5TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432122901",
            "telephone_number": "614-486-6755",
            "fax_number": "614-486-6781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWYER",
        "first_name": "BEAU",
        "middle_name": "SHANNON",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0914381",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; 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.