NPIMap

Organization Active NPI

F O R M E Medical & Rehab Center of Fremont, Inc

  • Chiropractor
  • Fremont, OH
National Provider Identifier
1629257019
Registry record updated Nov 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1523 Issued in OH
Legal business name
F O R M E MEDICAL & REHAB CENTER OF FREMONT, INC
Practice address
728 N Stone St
Fremont, OH 43420-1535
Phone
(419) 334-7600
Fax
(419) 334-7640
NPI assigned
Nov 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2010

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

Authorized official

Name
Dr. Paul Lynn Silcox, D.C.NPI 1992805642
Title
Owner/President
Phone
(419) 334-7600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1523 OH Primary

Addresses

Primary practice location

728 N Stone St
Fremont, OH 43420-1535

Mailing address

728 N Stone St
Fremont, OH 43420-1535
Phone (419) 334-7600

Other identifiers 2

IdentifierTypeStateIssuer
350022051OtherOHMEDICARE RAIL ROAD
2511660MedicaidOH

National Provider Directory

National Provider Directory

Locations

728 N Stone St
Fremont, OH 43420
Phone (419) 334-7600

Practitioners & affiliated clinicians

Practitioners 6

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": "1193875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290384000000",
    "number": "1629257019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 N STONE ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434201535",
            "telephone_number": "419-334-7600",
            "fax_number": "419-334-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 N STONE ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434201535",
            "telephone_number": "419-334-7600",
            "fax_number": "419-334-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "F O R M E MEDICAL & REHAB CENTER OF FREMONT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "last_updated": "2010-11-22",
        "status": "A",
        "authorized_official_last_name": "SILCOX",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "419-334-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "350022051",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2511660",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.