Organization Active NPI

Buckeye Spine & Rehab Inc

  • Physical Medicine & Rehabilitation Physician
  • Lancaster, OH
National Provider Identifier
1558490797
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
BUCKEYE SPINE & REHAB INC
Practice address
2036 Schorrway Dr NW
Box 847
Lancaster, OH 43130-8410
Phone
(740) 681-1582
Fax
(740) 681-1586
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Authorized official

Name
Mrs. Amy E Bretz, BILLER
Title
Credentialing
Phone
(740) 681-1582

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

2036 Schorrway Dr NW
Box 847
Lancaster, OH 43130-8410

Mailing address

2036 Schorrway Dr NW
Box 847
Lancaster, OH 43130-8410
Phone (740) 681-1582

Other identifiers 1

IdentifierTypeStateIssuer
2524987MedicaidOH

National Provider Directory

National Provider Directory

Locations

4850 E Main St
Ste 120
Whitehall, OH 43213
Phone (614) 575-6310

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413417600000",
    "number": "1558490797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2036 SCHORRWAY DR NW",
            "address_2": "BOX 847",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308410",
            "telephone_number": "740-681-1582",
            "fax_number": "740-681-1586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2036 SCHORRWAY DR NW",
            "address_2": "BOX 847",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308410",
            "telephone_number": "740-681-1582",
            "fax_number": "740-681-1586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKEYE SPINE & REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2014-10-16",
        "status": "A",
        "authorized_official_last_name": "BRETZ",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "740-681-1582",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BILLER"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2524987",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; 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.