NPIMap

Organization Active NPI

T L Sazdanoff DC Inc

Doing business as Sazdanoff Chiropractic Clinic

  • Chiropractor
  • Mansfield, OH
National Provider Identifier
1629186283
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
980 Issued in OH
Legal business name
T L SAZDANOFF DC INC
Doing business as
Sazdanoff Chiropractic Clinic
Practice address
990 Lexington Ave
Mansfield, OH 44907-2246
Phone
(419) 756-6111
Fax
(419) 756-2549
NPI assigned
Aug 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Authorized official

Name
Mrs. Stacey R Wolfe
Title
Ca
Phone
(419) 756-6111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 980 OH Primary

Addresses

Primary practice location

990 Lexington Ave
Mansfield, OH 44907-2246

Mailing address

990 Lexington Ave
Mansfield, OH 44907-2246
Phone (419) 756-6111

Other names 1

  • Sazdanoff Chiropractic Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040610000634 OH Part B Supplier - Clinic/Group Practice 3375526312 Receives reassigned benefits from 4 practitioners
Practice locations: Mansfield, OH

National Provider Directory

National Provider Directory

Locations

981 Ashland Rd
Mansfield, OH 44905
Phone (419) 709-9511

990 Lexington Ave
Mansfield, OH 44907
Phone (419) 756-6111

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1629186283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449072246",
            "telephone_number": "419-756-6111",
            "fax_number": "419-756-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449072246",
            "telephone_number": "419-756-6111",
            "fax_number": "419-756-2549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T L SAZDANOFF DC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CA",
        "authorized_official_telephone_number": "419-756-6111",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sazdanoff Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.

Verify at the official NPI Registry.