Individual provider Active NPI

Justin Ryan Herceg, DC

  • Chiropractor
  • Uniontown, OH
National Provider Identifier
1578872826
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4108 Issued in OH
Practice address
3570 Executive Dr
Suite 211
Uniontown, OH 44685-8712
Phone
(330) 563-4383
Fax
(330) 563-4874
NPI assigned
Oct 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4108 OH Primary

Addresses

Primary practice location

3570 Executive Dr
Suite 211
Uniontown, OH 44685-8712

Mailing address

3570 Executive Dr
Green, OH 44685-6713
Phone (330) 563-4383

Other identifiers 5

IdentifierTypeStateIssuer
1578872826OtherOHPERSONAL NPI
H198420OtherOHGROUP PTAN
1457691834OtherOHGROUP NPI
0078436MedicaidOH
H198421OtherOHINDIVIUAL PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131104001781 OH Practitioner - Chiropractic 7315172046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3570 Executive Dr
Suite 211
Uniontown, OH 44685-8712
Phone (330) 563-4383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4108OHMDChiropractor

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": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1578872826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3570 EXECUTIVE DR",
            "city": "GREEN",
            "state": "OH",
            "postal_code": "446856713",
            "telephone_number": "330-563-4383",
            "fax_number": "330-563-4874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3570 EXECUTIVE DR",
            "address_2": "SUITE 211",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "446858712",
            "telephone_number": "330-563-4383",
            "fax_number": "330-563-4874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERCEG",
        "first_name": "JUSTIN",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-05",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1578872826",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "H198420",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1457691834",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0078436",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIUAL PTAN",
            "identifier": "H198421",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Uniontown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; 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.