J Christopher Mariotti, DC
Individual provider Active NPI Chiropractor · Huron, OH
NPI 1629159157 · NPPES record last updated Jul 3, 2013
Key facts
- NPI
- 1629159157
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 683 (OH)
- Practice address
- 801 Rye Beach Road
Huron, OH 44839-2068 - Phone
- (419) 433-5432
- Fax
- (419) 433-5105
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
801 Rye Beach Rd
Huron, OH 44839-2068
Phone (419) 433-5432
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120309000110 | OH | Practitioner - Chiropractic | 0143489252 | Practice locations: Huron, OH |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 683 | OH | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Health Chiropractic, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 683 | OH | Yes |
Addresses
Primary practice location
801 Rye Beach Road
Huron, OH 44839-2068
Mailing address
801 Rye Beach Road
Huron, OH 44839-2068
Phone (419) 433-5432
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0694897 | Medicaid | OH |
Other providers in Huron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.