Individual provider Active NPI

Corey Brumbaugh

  • Chiropractor
  • Fairlawn, OH
National Provider Identifier
1437516648
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4595 Issued in OH
Practice address
2640 W Market St
Suite 101a
Fairlawn, OH 44333-4202
Phone
(330) 835-3005
Fax
(330) 835-3035
NPI assigned
Jan 19, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4595 OH Primary

Addresses

Primary practice location

2640 W Market St
Suite 101a
Fairlawn, OH 44333-4202

Mailing address

2640 W Market St
Suite 101a
Fairlawn, OH 44333-4202
Phone (330) 904-9890

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160302002734 OH Practitioner - Chiropractic 2062718901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brumbaugh Chiropractic LLCGroup PAC ID 1153627096, 2 clinicians

Practice addresses (Care Compare)

2640 W Market St
Suite 101a
Fairlawn, OH 44333-4202
Phone (330) 835-3005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4595OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brumbaugh Chiropractic LLC Chiropractor CurrentSince Jan 6, 2016 Accepting new patients
Wooster Family Chiropractic LLC Chiropractor Current Accepting new patients

Locations

2640 W Market St
Ste 101A
Fairlawn, OH 44333
Phone (330) 835-3005

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": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1437516648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 W MARKET ST",
            "address_2": "SUITE 101A",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334202",
            "telephone_number": "330-904-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 W MARKET ST",
            "address_2": "SUITE 101A",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334202",
            "telephone_number": "330-835-3005",
            "fax_number": "330-835-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMBAUGH",
        "first_name": "COREY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.