Organization Active NPI

Stow-Kent Chiropractic Clinic, Inc.

  • Chiropractor
  • Stow, OH
National Provider Identifier
1356486468
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
STOW-KENT CHIROPRACTIC CLINIC, INC.
Practice address
2991 Graham Rd
Stow, OH 44224-3619
Phone
(330) 686-1333
Fax
(330) 686-9275
NPI assigned
Feb 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael A. Shimmel, DOCTORNPI 1508843574
Title
Owner
Phone
(330) 686-1333

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2991 Graham Rd
Stow, OH 44224-3619

Mailing address

2991 Graham Rd
Stow, OH 44224-3619
Phone (330) 686-1333

Other identifiers 1

IdentifierTypeStateIssuer
0987615MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040921000759 OH Part B Supplier - Clinic/Group Practice 1456329192 Receives reassigned benefits from 1 practitioner
Practice locations: Stow, OH

National Provider Directory

National Provider Directory

Locations

2991 Graham Rd
Stow, OH 44224
Phone (216) 686-1333

Practitioners & affiliated clinicians

Practitioners 5

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356486468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2991 GRAHAM RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442243619",
            "telephone_number": "330-686-1333",
            "fax_number": "330-686-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2991 GRAHAM RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442243619",
            "telephone_number": "330-686-1333",
            "fax_number": "330-686-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOW-KENT CHIROPRACTIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHIMMEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-686-1333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DOCTOR"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0987615",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stow, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.