Organization Active NPI

Northwest Ohio Chiropractic, Inc.

  • Chiropractor
  • Bryan, OH
National Provider Identifier
1578864286
Registry record updated Nov 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
839 Issued in OH
Legal business name
NORTHWEST OHIO CHIROPRACTIC, INC.
Practice address
1304 W High St
Bryan, OH 43506-1544
Phone
(419) 636-5279
Fax
(419) 636-5805
NPI assigned
Nov 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2010

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

Authorized official

Name
Dr. Andre Gaulard, D.C.
Title
President
Phone
(419) 636-5279

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 839 OH Primary

Addresses

Primary practice location

1304 W High St
Bryan, OH 43506-1544

Mailing address

1304 W High St
Bryan, OH 43506-1544
Phone (419) 636-5279

Other identifiers 1

IdentifierTypeStateIssuer
0444488MedicaidOH

National Provider Directory

National Provider Directory

Locations

1304 W High St
Bryan, OH 43506
Phone (419) 636-5279

NPI Registry JSON

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289433600000",
    "number": "1578864286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 W HIGH ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061544",
            "telephone_number": "419-636-5279",
            "fax_number": "419-636-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 W HIGH ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061544",
            "telephone_number": "419-636-5279",
            "fax_number": "419-636-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST OHIO CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-11",
        "last_updated": "2010-11-11",
        "status": "A",
        "authorized_official_last_name": "GAULARD",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-636-5279",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0444488",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; 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.