Organization Active NPI

Oxford Medical Health & Wellness Center LLC

  • Chiropractor
  • Oxford, OH
National Provider Identifier
1356351464
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2292 Issued in OH
Legal business name
OXFORD MEDICAL HEALTH & WELLNESS CENTER LLC
Practice address
5144 College Corner Pike
Suite a
Oxford, OH 45056-2129
Phone
(513) 524-4800
Fax
(513) 523-8631
NPI assigned
Aug 9, 2006
Last updated
May 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Authorized official

Name
Dr. Stacy A Chidester, D.C.NPI 1043272032
Title
Owner/Operator
Phone
(513) 524-4800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2292 OH Primary
Sports Physical Therapist 2251S0007X 07243 OH

Addresses

Primary practice location

5144 College Corner Pike
Suite a
Oxford, OH 45056-2129

Mailing address

5144 College Corner Pike
Suite a
Oxford, OH 45056-2129
Phone (513) 524-4800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090922000219 OH Part B Supplier - Clinic/Group Practice 3375520224 Receives reassigned benefits from 1 practitioner
Practice locations: Oxford, OH

National Provider Directory

National Provider Directory

Locations

5144 College Corner Pike
Ste A
Oxford, OH 45056
Phone (513) 524-4800

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401235200000",
    "number": "1356351464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5144 COLLEGE CORNER PIKE",
            "address_2": "SUITE A",
            "city": "OXFORD",
            "state": "OH",
            "postal_code": "450562129",
            "telephone_number": "513-524-4800",
            "fax_number": "513-523-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5144 COLLEGE CORNER PIKE",
            "address_2": "SUITE A",
            "city": "OXFORD",
            "state": "OH",
            "postal_code": "450562129",
            "telephone_number": "513-524-4800",
            "fax_number": "513-523-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OXFORD MEDICAL HEALTH & WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2014-05-28",
        "status": "A",
        "authorized_official_last_name": "CHIDESTER",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "513-524-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2292",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "OH",
            "license": "07243",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.