Individual provider Active NPI

Steven Ray Prentice, DC

  • Chiropractor
  • Sandusky, OH
National Provider Identifier
1356328371
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2262 Issued in OH
Practice address
1723 Columbus Avenue
Suite B
Sandusky, OH 44870
Phone
(419) 621-7555
Fax
(419) 621-5597
NPI assigned
Dec 30, 2005
Last updated
Mar 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2262 OH Primary

Addresses

Primary practice location

1723 Columbus Avenue
Suite B
Sandusky, OH 44870

Mailing address

1723 Columbus Avenue
Suite B
Sandusky, OH 44870
Phone (419) 621-7555

Other identifiers 1

IdentifierTypeStateIssuer
0229176MedicaidOH

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
2262OHMDChiropractor

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, 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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1356328371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 COLUMBUS AVENUE",
            "address_2": "SUITE B",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "44870",
            "telephone_number": "419-621-7555",
            "fax_number": "419-621-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 COLUMBUS AVENUE",
            "address_2": "SUITE B",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "44870",
            "telephone_number": "419-621-7555",
            "fax_number": "419-621-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENTICE",
        "first_name": "STEVEN",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0229176",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.