Individual provider Active NPI

Justin Vinson, D.C.

  • Chiropractor
  • Beavercreek, OH
National Provider Identifier
1336541556
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4451 Issued in OH
Practice address
3060 Dayton Xenia Rd
Ste a
Beavercreek, OH 45434-6393
Phone
(937) 427-2225
Fax
(937) 405-1078
NPI assigned
Sep 18, 2014
Last updated
Oct 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X
Chiropractor 111N00000X 4451 OH Primary

Addresses

Primary practice location

3060 Dayton Xenia Rd
Ste a
Beavercreek, OH 45434-6393

Mailing address

3060 Dayton Xenia Rd
Ste a
Beavercreek, OH 45434-6393
Phone (937) 427-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141217001716 OH Practitioner - Chiropractic 9830412147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Medical and Wellness Center, Inc.Group PAC ID 0547536187, 5 clinicians

Practice addresses (Care Compare)

3060 Dayton Xenia Rd
Suite C
Beavercreek, OH 45434-6393
Phone (937) 427-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4451OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Medical & Wellness Center, Inc. CurrentSince Oct 1, 2017 Accepting new patients
Greg a.Hixon D.C., Inc. Chiropractor PastSince Oct 30, 2014 Accepting new patients

Locations

3060 Dayton Xenia Rd
Ste A
Dayton, OH 45434
Phone (937) 427-2225

3060 Dayton Xenia Rd
Ste C
Dayton, OH 45434
Phone (937) 427-2225

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": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1336541556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 DAYTON XENIA RD",
            "address_2": "STE A",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346393",
            "telephone_number": "937-427-2225",
            "fax_number": "937-405-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 DAYTON XENIA RD",
            "address_2": "STE A",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346393",
            "telephone_number": "937-427-2225",
            "fax_number": "937-405-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINSON",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-18",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.