Individual provider Active NPI

Lora Wolph, DC

  • Chiropractor
  • Fostoria, OH
National Provider Identifier
1679505713
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1859 Issued in OH
Practice address
123 S Main St
Fostoria, OH 44830-2309
Phone
(419) 436-0616
Fax
(419) 435-1622
NPI assigned
Jul 7, 2006
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1859 OH Primary

Addresses

Primary practice location

123 S Main St
Fostoria, OH 44830-2309

Mailing address

123 S Main St
Fostoria, OH 44830-2309
Phone (419) 436-0616

Other identifiers 2

IdentifierTypeStateIssuer
350045747OtherOHRAILROAD
0888491MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060907000590 OH Practitioner - Chiropractic 9032127063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wolph Chiropractic IncGroup PAC ID 3678581600, 2 clinicians

Practice addresses (Care Compare)

123 S Main St
Fostoria, OH 44830-2309
Phone (419) 436-0616

640 S Wintergarden Rd
Bowling Green, OH 43402-3544
Phone (419) 353-6394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1859OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wolph Chiropractic Inc Chiropractor CurrentSince May 19, 2006 Accepting new patients
Wolph Chiropractic, Inc. Chiropractor CurrentSince Sep 13, 1995 Accepting new patients

Locations

640 S Wintergarden Rd
Bowling Green, OH 43402
Phone (419) 352-1452

123 S Main St
Fostoria, OH 44830
Phone (419) 436-0616

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1679505713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 S MAIN ST",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "448302309",
            "telephone_number": "419-436-0616",
            "fax_number": "419-435-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S MAIN ST",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "448302309",
            "telephone_number": "419-436-0616",
            "fax_number": "419-435-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLPH",
        "first_name": "LORA",
        "name_prefix": "Mrs.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "350045747",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0888491",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fostoria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.