Barry John Kotheimer, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1511 Issued in OH

Practice address

102 E Park St
Chardon, OH 44024

Phone

(440) 286-2225

Fax

(440) 286-3058

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Chardon Family Chiropractic Clinic Inc.

  • Chiropractor
  • Chardon, OH
  • NPI 1689858169
  Medicare reassignment Authorized official
• Advanced Chardon Chiropractic Inc.

  • Chiropractor
  • Chardon, OH
  • NPI 1346424926
  NPD

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376615955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E PARK ST",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "44024",
            "telephone_number": "440-286-2225",
            "fax_number": "440-286-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E PARK ST",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "44024",
            "telephone_number": "440-286-2225",
            "fax_number": "440-286-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTHEIMER",
        "first_name": "BARRY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0759479",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alisa Korn, PT, DPT, CSCS
• Diane Kornblum
• Madeline Korth, LISW
• Bianca Marie Kostranchuk, O.D.
• Silvana Kostura
• Deborah Lynn Kowal
• Kim Elizabeth Koynock, MA, AT, LPC
• Brandi Kraynik
• John Collin Krebs, MD
• Alyssa Michelle Kreider, PHARMD

• Chiropractor in Chardon, OH
• Providers in Chardon, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.