Bernard P. Bubanic, DC DACBSP

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

1307 Issued in OH

Practice address

4082 Fulton Drive NW
Canton, OH 44718

Phone

(330) 491-8100

Fax

(844) 572-2173

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bubanic Chiropractic, IncGroup PAC ID 1456440619, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bubanic Chiropractic Inc.

  • Chiropractor
  • Canton, OH
  • NPI 1912187758
  Medicare reassignment Care Compare group NPD Authorized official
• Rich Health and Wellness Inc

  • Family Medicine Physician
  • Canton, OH
  • NPI 1477645455
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1629174222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4082 FULTON DRIVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44718",
            "telephone_number": "330-491-8100",
            "fax_number": "844-572-2173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4082 FULTON DRIVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44718",
            "telephone_number": "330-491-8100",
            "fax_number": "844-572-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUBANIC",
        "first_name": "BERNARD",
        "middle_name": "P.",
        "credential": "DC DACBSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OH",
            "license": "1307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0701351",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane Brunker
• Gerard J Bruno, DDS
• Craig Bryant, MD
• Mark Bryant, O.D.
• Bubanic Chiropractic Inc.
• Troy Bubanic, DC
• Shelby Lauren Bucceri, CNS
• James Mitchell Buccigross, PH.D., DABPS
• Zakree Buccitelli, LPC
• Elaine Buch, CRNA

• Sports Physician Chiropractor in Canton, OH
• Providers in Canton, OH by specialty
• Sports Physician Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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.