Organization Active NPI

Pinnacle Chiropractic and Physical Therapy

Doing business as Advanced Spine, Rehab and Athletics

  • Chiropractor
  • Etna, OH
National Provider Identifier
1447643697
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3618 Issued in OH
Legal business name
PINNACLE CHIROPRACTIC AND PHYSICAL THERAPY
Doing business as
Advanced Spine, Rehab and Athletics
Practice address
9315 Columbia Rd SW
Etna, OH 43062-7126
Phone
(740) 963-3900
Fax
(740) 963-3999
NPI assigned
Mar 12, 2015
Last updated
May 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Authorized official

Name
Amanda Stevenson, DC
Title
Doctor
Phone
(740) 966-0068

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3618 OH Primary
Massage Therapist 225700000X 33.021808 E-G OH

Addresses

Primary practice location

9315 Columbia Rd SW
Etna, OH 43062-7126

Mailing address

9315 Columbia Rd SW
Etna, OH 43062-7126
Phone (740) 963-3900

Other names 1

  • Advanced Spine, Rehab and Athletics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150602001133 OH Part B Supplier - Clinic/Group Practice 3678894722 Receives reassigned benefits from 1 practitioner
Practice locations: Etna, OH

National Provider Directory

National Provider Directory

Locations

9315 Columbia Rd SW
Etna, OH 43062
Phone (740) 963-3900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1447643697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9315 COLUMBIA RD SW",
            "city": "ETNA",
            "state": "OH",
            "postal_code": "430627126",
            "telephone_number": "740-963-3900",
            "fax_number": "740-963-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9315 COLUMBIA RD SW",
            "city": "ETNA",
            "state": "OH",
            "postal_code": "430627126",
            "telephone_number": "740-963-3900",
            "fax_number": "740-963-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE CHIROPRACTIC AND PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-12",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "STEVENSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "740-966-0068",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3618",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "33.021808 E-G",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Spine, Rehab and Athletics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Etna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.