Organization Active NPI

Chagrin Valley Chiropractic and Acupuncture Center, LLC

  • Chiropractor
  • Chagrin Falls, OH
National Provider Identifier
1386836906
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
011151 Issued in NY
Legal business name
CHAGRIN VALLEY CHIROPRACTIC AND ACUPUNCTURE CENTER, LLC
Practice address
516 Washington St
Ste D
Chagrin Falls, OH 44022-4402
Phone
(440) 247-5383
NPI assigned
Aug 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Authorized official

Name
Dr. Ivan Alan Nassif, D.C.NPI 1407831423
Title
Owner
Phone
(440) 247-5383

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 011151 NY Primary

Addresses

Primary practice location

516 Washington St
Ste D
Chagrin Falls, OH 44022-4402

Mailing address

516 Washington St
Ste D
Chagrin Falls, OH 44022-4402
Phone (440) 247-5383

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071010000665 OH Part B Supplier - Clinic/Group Practice 2860588555 Receives reassigned benefits from 1 practitioner
Practice locations: Chagrin Falls, OH

National Provider Directory

National Provider Directory

Locations

529 Washington St
#200
Chagrin Falls, OH 44022
Phone (440) 247-5383

7170 Chagrin Rd
Chagrin Falls, OH 44023
Phone (440) 247-5383

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346284800000",
    "number": "1386836906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 WASHINGTON ST",
            "address_2": "STE D",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440224402",
            "telephone_number": "440-247-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 WASHINGTON ST",
            "address_2": "STE D",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440224402",
            "telephone_number": "440-247-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAGRIN VALLEY CHIROPRACTIC AND ACUPUNCTURE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2012-08-30",
        "status": "A",
        "authorized_official_last_name": "NASSIF",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-247-5383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "011151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chagrin Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.