NPIMap

Organization Active NPI

Minerva Chiropractic Center Inc.

  • Chiropractor
  • Minerva, OH
National Provider Identifier
1477889152
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2054 OH Issued in OH
Legal business name
MINERVA CHIROPRACTIC CENTER INC.
Practice address
15245 Lincoln St SE
Minerva, OH 44657-8559
Phone
(330) 868-7539
Fax
(330) 868-5719
NPI assigned
Oct 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Authorized official

Name
Dr. Robert Kenneth Nichols, D.C.
Title
Owner/Doctor Practicing
Phone
(330) 868-7539

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2054 OH OH Primary

Addresses

Primary practice location

15245 Lincoln St SE
Minerva, OH 44657-8559

Mailing address

15245 Lincoln St SE
Minerva, OH 44657-8559
Phone (330) 868-7539

Other identifiers 1

IdentifierTypeStateIssuer
0960385MedicaidOH

National Provider Directory

National Provider Directory

Locations

15245 W Lincolnway
Minerva, OH 44657
Phone (330) 771-1060

NPI Registry JSON

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374796800000",
    "number": "1477889152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15245 LINCOLN ST SE",
            "city": "MINERVA",
            "state": "OH",
            "postal_code": "446578559",
            "telephone_number": "330-868-7539",
            "fax_number": "330-868-5719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15245 LINCOLN ST SE",
            "city": "MINERVA",
            "state": "OH",
            "postal_code": "446578559",
            "telephone_number": "330-868-7539",
            "fax_number": "330-868-5719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINERVA CHIROPRACTIC CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-30",
        "last_updated": "2013-07-26",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER/DOCTOR PRACTICING",
        "authorized_official_telephone_number": "330-868-7539",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2054 OH",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0960385",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minerva, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.