Jason T Marucci, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH7589 Issued in FL

Practice address

755 Boardman Canfield Rd
Southbridge West, Building P Unit 1
Boardman, OH 44512-4300

Phone

(330) 286-3669

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Performance PT

  • Physical Therapy Clinic/Center
  • Canfield, OH
  • NPI 1316375066
  NPD Authorized official

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1689665168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 BOARDMAN CANFIELD RD",
            "address_2": "SOUTHBRIDGE WEST, BUILDING P UNIT 1",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124300",
            "telephone_number": "330-286-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 BOARDMAN CANFIELD RD",
            "address_2": "SOUTHBRIDGE WEST, BUILDING P UNIT 1",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124300",
            "telephone_number": "330-286-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARUCCI",
        "first_name": "JASON",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2794132",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381768700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "9375191",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April L Maro, RN
• April Martin
• Don Martin, PHD
• Shannon Marie Martin, RD
• Tiffany Lynn Martino, LPN
• Masco, Inc
• Jack Russell Mashburn, HAS
• Cadi Jane Masi, BA, BCABA
• Tedmund R Mason, PAC
• Hannah Massa, OD

• Chiropractor in Boardman, OH
• Providers in Boardman, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.