Individual provider Active NPI

Jeffrey S. Chivington, D.C.

  • Chiropractor
  • St. Marys, OH
National Provider Identifier
1386649457
Registry record updated Jan 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2355 Issued in OH
Practice address
575 Royal Oak Drive
St. Marys, OH 45885
Phone
(419) 394-7124
Fax
(419) 394-4288
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2355 OH Primary

Addresses

Primary practice location

575 Royal Oak Drive
St. Marys, OH 45885

Mailing address

575 Royal Oak Drive
St. Marys, OH 45885
Phone (419) 394-7124

Other identifiers 1

IdentifierTypeStateIssuer
0297923MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100830000039 OH Practitioner - Chiropractic 0143344002 Practice locations: Saint Marys, OH

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

575 Royal Oak Dr
Saint Marys, OH 45885-1465
Phone (419) 394-7124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2355OHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
William a. Kentris, D.C. Inc Chiropractor Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 2

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515369600000",
    "number": "1386649457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 ROYAL OAK DRIVE",
            "city": "ST. MARYS",
            "state": "OH",
            "postal_code": "45885",
            "telephone_number": "419-394-7124",
            "fax_number": "419-394-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 ROYAL OAK DRIVE",
            "city": "ST. MARYS",
            "state": "OH",
            "postal_code": "45885",
            "telephone_number": "419-394-7124",
            "fax_number": "419-394-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIVINGTON",
        "first_name": "JEFFREY",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2018-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0297923",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Marys, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; 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.