NPIMap

Organization Active NPI

McBrearty Family & Sport Chiropractic,LLC

  • Sports Physician Chiropractor
  • Canton, OH
National Provider Identifier
1437218492
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
3710 Issued in OH
Legal business name
MCBREARTY FAMILY & SPORT CHIROPRACTIC,LLC
Practice address
807 30TH St NE
Canton, OH 44714-1404
Phone
(330) 491-0381
Fax
(330) 491-0388
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2012

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

Authorized official

Name
Dr. Patrick Joseph McBrearty, D.C.NPI 1649249020
Title
Doctor
Phone
(330) 491-0381

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
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X 3710 OH Primary

Addresses

Primary practice location

807 30TH St NE
Canton, OH 44714-1404

Mailing address

807 30TH St NE
Canton, OH 44714-1404
Phone (330) 491-0381

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070219000041 OH Part B Supplier - Clinic/Group Practice 5496857773 Receives reassigned benefits from 4 practitioners
Practice locations: Canton, OH

National Provider Directory

National Provider Directory

Locations

807 30th St NE
Canton, OH 44714
Phone (330) 491-0381

Practitioners & affiliated clinicians

Practitioners 9

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": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1437218492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 30TH ST NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447141404",
            "telephone_number": "330-491-0381",
            "fax_number": "330-491-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 30TH ST NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447141404",
            "telephone_number": "330-491-0381",
            "fax_number": "330-491-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCBREARTY FAMILY & SPORT CHIROPRACTIC,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "MCBREARTY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "330-491-0381",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "OH",
            "license": "3710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.