Individual provider Active NPI

Jon W Schwanz, D.C.

  • Thermography Chiropractor
  • Waterville, OH
National Provider Identifier
1407833817
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thermography ChiropractorTaxonomy code 111NT0100X
License
1201 Issued in OH
Practice address
1222 Pray Blvd Ste 1
Waterville, OH 43566-8717
Phone
(419) 878-8142
Fax
(419) 878-8143
NPI assigned
Dec 28, 2005
Last updated
Sep 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1201 OH
Thermography Chiropractor 111NT0100X 1201 OH Primary

Addresses

Primary practice location

1222 Pray Blvd Ste 1
Waterville, OH 43566-8717

Mailing address

1222 Pray Blvd Ste 1
Waterville, OH 43566-8717
Phone (419) 878-8142

Other identifiers 1

IdentifierTypeStateIssuer
0632855MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100205000149 OH Practitioner - Chiropractic 1355484817 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1201OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rebel Chiropractic LLC Chiropractor CurrentSince Jan 1, 2017 Accepting new patients

Locations

1222 Pray Blvd
#1
Waterville, OH 43566
Phone (419) 878-8142

216 South St
Waterville, OH 43566
Phone (419) 878-8142

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1407833817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 PRAY BLVD STE 1",
            "city": "WATERVILLE",
            "state": "OH",
            "postal_code": "435668717",
            "telephone_number": "419-878-8142",
            "fax_number": "419-878-8143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 PRAY BLVD STE 1",
            "city": "WATERVILLE",
            "state": "OH",
            "postal_code": "435668717",
            "telephone_number": "419-878-8142",
            "fax_number": "419-878-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWANZ",
        "first_name": "JON",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1201",
            "primary": false
        },
        {
            "code": "111NT0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Thermography",
            "state": "OH",
            "license": "1201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0632855",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.