Steven Lee Eddy, DC – Chiropractor

Key facts

NPI: 1689675977
Entity type: Individual (NPI type 1)
Primary specialty: Chiropractor 111N00000X
License: 575 (WV)
Practice address: 443 Highland Ave
Williamstown, WV 26187-1247
Phone: (304) 375-6000
Fax: (304) 375-6043
NPI assigned: Aug 9, 2005
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

Eddy Chiropractic Clinic Inc Chiropractor · Williamstown, WV · NPI 1760413454

Medicare reassignment Care Compare group NPD Authorized official CHIROPRACTOR · WV

Medicare Care Compare profile

Specialty: Chiropractic
Education: Life Chiropractic College, 1992
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Eddy Chiropractic Clinic Inc (2 clinicians)

Practice addresses (Care Compare)

443 Highland Ave
Williamstown, WV 26187-1247
Phone (304) 375-6000

Medicare participation

Medicare fee-for-service enrollment: Enrolled in WV

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20110124000131	WV	Practitioner - Chiropractic	4183690258	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
575	WV	MD	Clinical Psychologist

Practice roles

Organization	Specialty	Status	New patients
Eddy Chiropractic Clinic Inc	Chiropractor	Current since Jan 1, 1994	Accepting new patients

Locations

443 Highland Ave
Williamstown, WV 26187
Phone (304) 375-6000

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor	111N00000X	575	WV	Yes

Addresses

Primary practice location

443 Highland Ave
Williamstown, WV 26187-1247

Mailing address

443 Highland Ave
Williamstown, WV 26187-1247
Phone (304) 375-6000

Other identifiers

Identifier	Type	State	Issuer
0131911000	Medicaid	WV
5564005	Other		AETNA
6617161	Other		CIGNA
1840104	Other		FIRST HEALTH NETWORK
389303	Other		MAMSI
151727900	Other		ACS
550785922001	Other		BC BS
0952938	Medicaid	OH

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 13, 2013.

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1689675977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 HIGHLAND AVE",
            "city": "WILLIAMSTOWN",
            "state": "WV",
            "postal_code": "261871247",
            "telephone_number": "304-375-6000",
            "fax_number": "304-375-6043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "443 HIGHLAND AVE",
            "city": "WILLIAMSTOWN",
            "state": "WV",
            "postal_code": "261871247",
            "telephone_number": "304-375-6000",
            "fax_number": "304-375-6043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDY",
        "first_name": "STEVEN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0131911000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5564005",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6617161",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH NETWORK",
            "identifier": "1840104",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "389303",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS",
            "identifier": "151727900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "550785922001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0952938",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamstown, WV

All providers in Williamstown, WV · Chiropractor in West Virginia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.