Individual provider Active NPI

Anthony D Erwin, DC

  • Rehabilitation Chiropractor
  • Hurricane, WV
National Provider Identifier
1396749784
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
821 Issued in WV
Practice address
3551 Teays Valley Rd
Hurricane, WV 25526-9054
Phone
(304) 757-7668
Fax
(304) 757-9045
NPI assigned
Jun 13, 2005
Reactivated
Mar 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 821 WV Primary

Addresses

Primary practice location

3551 Teays Valley Rd
Hurricane, WV 25526-9054

Mailing address

13 Renard Run
Hurricane, WV 25526-8714
Phone (304) 757-2860

Other identifiers 1

IdentifierTypeStateIssuer
3810004499MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050804000314 WV Practitioner - Chiropractic 0840229456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3551 Teays Valley Rd
Hurricane, WV 25526-9054
Phone (304) 757-7668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
821WVMDClinical Psychologist

Organizations & group practices 1

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396749784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 RENARD RUN",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255268714",
            "telephone_number": "304-757-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 TEAYS VALLEY RD",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269054",
            "telephone_number": "304-757-7668",
            "fax_number": "304-757-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERWIN",
        "first_name": "ANTHONY",
        "middle_name": "D",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WV",
            "license": "821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004499",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurricane, WV

Sources for this page

  • 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.