Individual provider Active NPI

Chanda Jean Longworth, D.C.

  • Chiropractor
  • North Canton, OH
National Provider Identifier
1568916872
Registry record updated Jul 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4646 Issued in OH
Practice address
7023 Mears Gate Dr NW Ste B
North Canton, OH 44720-8849
Phone
(330) 494-5554
Fax
(330) 494-2792
NPI assigned
Aug 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4646 OH Primary

Addresses

Primary practice location

7023 Mears Gate Dr NW Ste B
North Canton, OH 44720-8849

Mailing address

7023 Mears Gate Dr NW
Ste B
North Canton, OH 44720-8849
Phone (330) 494-5554

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200305002972 OH Practitioner - Chiropractic 3577998657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Longworth Chiropractic Clinic IncGroup PAC ID 0840625927, 2 clinicians

Practice addresses (Care Compare)

7023 Mears Gate Dr NW
Suite B
North Canton, OH 44720-8800
Phone (330) 494-5554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4646OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Longworth Chiropractic Clinic Inc Chiropractor CurrentSince Feb 1, 2020 Accepting new patients

Locations

7023 Mears Gate Dr NW
North Canton, OH 44720
Phone (330) 494-5554

7023 Mears Gate Dr NW
Ste B
North Canton, OH 44720
Phone (330) 494-5554

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501027200000",
    "number": "1568916872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7023 MEARS GATE DR NW",
            "address_2": "STE B",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447208849",
            "telephone_number": "330-494-5554",
            "fax_number": "330-494-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7023 MEARS GATE DR NW STE B",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447208849",
            "telephone_number": "330-494-5554",
            "fax_number": "330-494-2792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGWORTH",
        "first_name": "CHANDA",
        "middle_name": "JEAN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2017-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.