East Mentor Family Chiropractic & Rehabilitation, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2782 Issued in OH

Legal business name

EAST MENTOR FAMILY CHIROPRACTIC & REHABILITATION, INC.

Practice address

6966 Heisley Rd
Suite F
Mentor, OH 44060-4593

Phone

(440) 974-8557

Fax

(440) 255-6337

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Russell Ward, D.C.NPI 1356377360

Title

President

Phone

(440) 974-8557

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Russell Ward, D.C.

  • Chiropractor
  • Mentor, OH
  • NPI 1356377360
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1487775706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6966 HEISLEY RD",
            "address_2": "SUITE F",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604593",
            "telephone_number": "440-974-8557",
            "fax_number": "440-255-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6966 HEISLEY RD",
            "address_2": "SUITE F",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604593",
            "telephone_number": "440-974-8557",
            "fax_number": "440-255-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST MENTOR FAMILY CHIROPRACTIC & REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-974-8557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2131571",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron Dunlany
• Susan M Dykeman, MD
• E. V. Decastecker DDS Inc
• Eagen Management Inc.
• Earmark Audiology
• Susan Eastabrooks, CNP
• Mary Melissa Eaton, LISW
• Gary Mark Echt, LPCC LICDC
• Colin James Ecker, PHARMD
• Sergio Lynn Eddie, MSW, LSW

• Chiropractor in Mentor, OH
• Providers in Mentor, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; 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.