Organization Active NPI

Creekside Chiropractic Center

  • Chiropractor
  • Gahanna, OH
National Provider Identifier
1649459165
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2092 Issued in OH
Legal business name
CREEKSIDE CHIROPRACTIC CENTER
Practice address
960 N Hamilton Rd
Suite 104
Gahanna, OH 43230-3457
Phone
(614) 472-0992
Fax
(614) 472-0994
NPI assigned
Nov 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Authorized official

Name
Jodi Luaine CooleyNPI 1265492532
Title
Owner
Phone
(614) 472-0992

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 2092 OH Primary

Addresses

Primary practice location

960 N Hamilton Rd
Suite 104
Gahanna, OH 43230-3457

Mailing address

960 N Hamilton Rd
Suite 104
Gahanna, OH 43230-3457
Phone (614) 472-0992

Other identifiers 1

IdentifierTypeStateIssuer
2790850MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071205000116 OH Part B Supplier - Clinic/Group Practice 4981793585 Receives reassigned benefits from 3 practitioners
Practice locations: Gahanna, OH

National Provider Directory

National Provider Directory

Locations

136 Mill St
Ste 120
Gahanna, OH 43230
Phone (614) 472-0992

Practitioners & affiliated clinicians

Practitioners 4

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": "1763337600000",
    "number": "1649459165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 N HAMILTON RD",
            "address_2": "SUITE 104",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432303457",
            "telephone_number": "614-472-0992",
            "fax_number": "614-472-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 N HAMILTON RD",
            "address_2": "SUITE 104",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432303457",
            "telephone_number": "614-472-0992",
            "fax_number": "614-472-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A",
        "authorized_official_last_name": "COOLEY",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "LUAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-472-0992"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2790850",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gahanna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; 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.