Chardon Family Chiropractic Clinic Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1511 Issued in OH

Legal business name

CHARDON FAMILY CHIROPRACTIC CLINIC INC.

Practice address

102 East Park Street
Chardon, OH 44024-1237

Phone

(440) 286-2225

Fax

(440) 286-3058

NPI assigned

Dec 20, 2007

Last updated

Jan 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Barry J Kotheimer, D.C.NPI 1376615955

Title

President

Phone

(440) 286-2225

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Barry John Kotheimer, DC

  • Chiropractor
  • Chardon, OH
  • NPI 1376615955
  Medicare reassignment Authorized official
• David Anthony Berman, D.C.

  • Chiropractor
  • Chardon, OH
  • NPI 1922174762
  NPD

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1689858169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 EAST PARK STREET",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241237",
            "telephone_number": "440-286-2225",
            "fax_number": "440-286-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 EAST PARK STREET",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241237",
            "telephone_number": "440-286-2225",
            "fax_number": "440-286-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARDON FAMILY CHIROPRACTIC CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "KOTHEIMER",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-286-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0759479",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cathy Pappas Bravo, O.D., Inc.
• Abigail Chaddock
• Chagrin Valley Foot and Ankle Specialists Inc
• Madeline Chandler
• Kasandra Leigh Chapman
• Chardon Family Eyecare LLC
• Chardon Fire Department Inc (Chardon Fire Department)
• Chardon Integrated Wellness Center, LLC
• Chardon Local School District
• Chardon Physical Therapy LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; 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.