Individual provider Active NPI

Daniel L Stroup, D.C.

  • Chiropractor
  • Shelby, OH
National Provider Identifier
1588795918
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2337 Issued in OH
Practice address
110 W Smiley Ave
Shelby, OH 44875-2130
Phone
(419) 342-6000
Fax
(419) 342-6002
NPI assigned
Mar 8, 2007
Last updated
Nov 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2337 OH Primary

Addresses

Primary practice location

110 W Smiley Ave
Shelby, OH 44875-2130

Mailing address

110 W Smiley Ave
Shelby, OH 44875-2130
Phone (419) 342-6000

Other identifiers 3

IdentifierTypeStateIssuer
2765502MedicaidOH
34-1444686OtherOHTAX IDENTIFICATION
46-1261658OtherOHTAX IDENTIFICATION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040611000945 OH Practitioner - Chiropractic 4688657398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

110 W Smiley Ave
Suite 3
Shelby, OH 44875-2130
Phone (419) 342-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2337OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Stroup Chiropractic Clinic, Inc. Chiropractor CurrentSince Dec 26, 2012 Accepting new patients
T L Sazdanoff DC Inc Chiropractor Past Accepting new patients

Locations

110 W Smiley Ave
Shelby, OH 44875
Phone (419) 342-2812

110 W Smiley Ave
Ste 3
Shelby, OH 44875
Phone (419) 342-6000

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1588795918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W SMILEY AVE",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448752130",
            "telephone_number": "419-342-6000",
            "fax_number": "419-342-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W SMILEY AVE",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448752130",
            "telephone_number": "419-342-6000",
            "fax_number": "419-342-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROUP",
        "first_name": "DANIEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2765502",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "34-1444686",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "46-1261658",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2012; 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.