Active NPI
Jeffrey Steven Fedorko, DC
- Chiropractor
- Canton, OH
National Provider Identifier
1598861726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 919
- Practice address
- 4774 Munson St NW
#302
Canton, OH 44718-3634 - Phone
- (330) 494-0422
- Fax
- (330) 494-3601
- NPI assigned
- Sep 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 919 | OH | Primary |
Addresses
Primary practice location
4774 Munson St NW
#302
Canton, OH 44718-3634
Mailing address
4774 Munson St NW
#302
Canton, OH 44718-3634
Phone (330) 494-0422
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 645289 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fedorko Chiropractic Health Ctr | Chiropractor | Past | Accepting new patients |
| Fedorko Chiropractic Health Ctr of Green | Chiropractor | Past | Accepting new patients |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Canton, OH
- NPI 1750972394
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 and National Provider Directory roles.
-
- Chiropractor
- Canton, OH
- NPI 1144326356
-
- Chiropractor
- Uniontown, OH
- NPI 1770678799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598861726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4774 MUNSON ST NW",
"address_2": "#302",
"city": "CANTON",
"state": "OH",
"postal_code": "447183634",
"telephone_number": "330-494-0422",
"fax_number": "330-494-3601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4774 MUNSON ST NW",
"address_2": "#302",
"city": "CANTON",
"state": "OH",
"postal_code": "447183634",
"telephone_number": "330-494-0422",
"fax_number": "330-494-3601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDORKO",
"first_name": "JEFFREY",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OH",
"license": "919",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "645289",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.