Individual provider Active NPI

John Gerard Restaino, DC

  • Chiropractor
  • Ft Wright, KY
National Provider Identifier
1447360664
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4304 Issued in KY
Practice address
1671 Park Rd
Suite 21
Ft Wright, KY 41011
Phone
(859) 578-8778
Fax
(859) 578-8777
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Chiropractor 111N00000X 4304 KY Primary

Addresses

Primary practice location

1671 Park Rd
Suite 21
Ft Wright, KY 41011

Mailing address

1671 Park Rd
Suite 21
Ft Wright, KY 41011
Phone (859) 578-8778

Other identifiers 1

IdentifierTypeStateIssuer
85036341MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050705000425 OH Practitioner - Chiropractic 5698714962 Reassigns benefits to 1 organization
I20060117000039 KY Practitioner - Chiropractic 5698714962 Practice locations: Ft Wright, KY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1671 Park Rd
Ft Wright, KY 41011-2769
Phone (859) 578-8778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4304KYMDChiropractor
2388OHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Chiropractic LLC Chiropractor CurrentSince Apr 1, 2000 Accepting new patients

Locations

2601 Needmore Rd
Dayton, OH 45414
Phone (937) 277-7246

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, 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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447360664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1671 PARK RD",
            "address_2": "SUITE 21",
            "city": "FT WRIGHT",
            "state": "KY",
            "postal_code": "41011",
            "telephone_number": "859-578-8778",
            "fax_number": "859-578-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1671 PARK RD",
            "address_2": "SUITE 21",
            "city": "FT WRIGHT",
            "state": "KY",
            "postal_code": "41011",
            "telephone_number": "859-578-8778",
            "fax_number": "859-578-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESTAINO",
        "first_name": "JOHN",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85036341",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Wright, KY

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.