Individual provider Active NPI

Nathan Phillips, DC

  • Chiropractor
  • Sandusky, OH
National Provider Identifier
1639799299
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-04963 Issued in OH
Practice address
3703 Columbus Ave
Sandusky, OH 44870-5719
Phone
(419) 625-8085
Fax
(419) 625-6004
NPI assigned
Apr 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-04963 OH Primary

Addresses

Primary practice location

3703 Columbus Ave
Sandusky, OH 44870-5719

Mailing address

3703 Columbus Ave
Sandusky, OH 44870-5719
Phone (419) 625-8085

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200514002423 OH Practitioner - Chiropractic 1456782036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sandusky Wellness Center IncGroup PAC ID 2062319940, 5 clinicians

Practice addresses (Care Compare)

3703 Columbus Ave
Sandusky, OH 44870-5719
Phone (419) 625-8085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sandusky Wellness Center Inc Chiropractor CurrentSince Apr 7, 2020 Accepting new patients
Sandusky Wellness DME LLC PastSince Apr 7, 2020 Accepting new patients

Locations

3703 Columbus Ave
Sandusky, OH 44870
Phone (419) 625-8085

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.

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1639799299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 COLUMBUS AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705719",
            "telephone_number": "419-625-8085",
            "fax_number": "419-625-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 COLUMBUS AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705719",
            "telephone_number": "419-625-8085",
            "fax_number": "419-625-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "NATHAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-23",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC-04963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.