Individual provider Active NPI

Brian Clancy Vetter, D.C.

  • Chiropractor
  • Olmsted Falls, OH
National Provider Identifier
1689877227
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4131 Issued in OH
Practice address
8137 Columbia Rd
Olmsted Falls, OH 44138-2023
Phone
(440) 427-1602
Fax
(440) 427-1598
NPI assigned
Jun 11, 2007
Last updated
Oct 7, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X011506-1 NY
Chiropractor 111N00000X 4131 OH Primary

Addresses

Primary practice location

8137 Columbia Rd
Olmsted Falls, OH 44138-2023

Mailing address

8137 Columbia Rd
Olmsted Falls, OH 44138-2023
Phone (440) 427-1602

Other identifiers 1

IdentifierTypeStateIssuer
0093969MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110413000746 OH Practitioner - Chiropractic 1355425844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8137 Columbia Rd
Olmsted Falls, OH 44138-2023
Phone (440) 427-1602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
X011506-1NYMDChiropractor
4131OHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Brian C Vetter Chiropractor PC Chiropractor CurrentSince Jan 27, 2011 Accepting new patients

Locations

8137 Columbia Rd
Olmsted Falls, OH 44138
Phone (440) 427-1602

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, 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": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1689877227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8137 COLUMBIA RD",
            "city": "OLMSTED FALLS",
            "state": "OH",
            "postal_code": "441382023",
            "telephone_number": "440-427-1602",
            "fax_number": "440-427-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8137 COLUMBIA RD",
            "city": "OLMSTED FALLS",
            "state": "OH",
            "postal_code": "441382023",
            "telephone_number": "440-427-1602",
            "fax_number": "440-427-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETTER",
        "first_name": "BRIAN",
        "middle_name": "CLANCY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011506-1",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0093969",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olmsted Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.