Individual provider Active NPI

Rusty V Whiteamire, D.C.

  • Chiropractor
  • Mansfield, OH
National Provider Identifier
1346348794
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-00872 Issued in OH
Practice address
2031 Park Ave W
Mansfield, OH 44906-2234
Phone
(419) 529-2055
Fax
(419) 529-6085
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0872 OH
Chiropractor 111N00000X DC-00872 OH Primary

Addresses

Primary practice location

2031 Park Ave W
Mansfield, OH 44906-2234

Mailing address

2031 Park Ave W
Ontario, OH 44906-2234
Phone (419) 631-1072

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
0872OHMDChiropractor
DC-00872OHMDChiropractor
872OHMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Ontario Medical Spine and Joint LLC PastSince Oct 4, 2020 Accepting new patients

Organizations & group practices 1

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1346348794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 PARK AVE W",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449062234",
            "telephone_number": "419-631-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 PARK AVE W",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449062234",
            "telephone_number": "419-529-2055",
            "fax_number": "419-529-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEAMIRE",
        "first_name": "RUSTY",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "0872",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC-00872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.