Lavalette Chiropractic Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

691 Issued in WV

Legal business name

LAVALETTE CHIROPRACTIC INC

Practice address

4600A Route 152
Lavalette, WV 25535

Phone

(304) 522-7246

Fax

(304) 522-0018

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John Samuel Fry, D.C.NPI 1841233806

Title

President

Phone

(304) 522-7246

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Locations

Practitioners 1

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

• John Samuel Fry, D.C.

  • Chiropractor
  • Ceredo, WV
  • NPI 1841233806
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1548349442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1177",
            "city": "LAVALETTE",
            "state": "WV",
            "postal_code": "255351177",
            "telephone_number": "304-522-7246",
            "fax_number": "304-522-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600A ROUTE 152",
            "city": "LAVALETTE",
            "state": "WV",
            "postal_code": "25535",
            "telephone_number": "304-522-7246",
            "fax_number": "304-522-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVALETTE CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "FRY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-522-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV WORKERS COMP VENDOR",
            "identifier": "1066162",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER",
            "identifier": "P00195054",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7600032000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "001720189",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR JOHN FRY, DC",
            "identifier": "1841233806",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nattia Inyangette
• Chester G Kaczor, PHARM.D.
• Grace Avena Kazee
• Kayla Kendrick
• Jessica Lane
• Lavalette Volunteer Fire Dept
• Jennifer Lewis
• Mainstream Services, Incorporated
• Felicia Mastrangelo
• Georgia Maynard

• Chiropractor in Lavalette, WV
• Providers in Lavalette, WV by specialty
• Chiropractor in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.