Individual provider Active NPI

Robert Wrightsmen Shaffer, D.C.

  • Chiropractor
  • Englewood, OH
National Provider Identifier
1699711960
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1345 Issued in OH
Practice address
713 Taywood Rd
Englewood, OH 45322-1822
Phone
(937) 558-1256
Fax
(937) 558-1273
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1345 OH Primary

Addresses

Primary practice location

713 Taywood Rd
Englewood, OH 45322-1822

Mailing address

713 Taywood Rd
Englewood, OH 45322-1822
Phone (937) 558-1256

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041012000680 OH Practitioner - Chiropractic 4082674379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shank Chiropractic Clinic LLCGroup PAC ID 8729039219, 2 clinicians

Practice addresses (Care Compare)

713 Taywood Rd
Englewood, OH 45322-1822
Phone (937) 558-1256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1345OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Shank Chiropractic Clinic LLC Chiropractor CurrentSince Dec 1, 2006 Accepting new patients

Locations

713 Taywood Rd
Englewood, OH 45322
Phone (937) 558-1256

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.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699711960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 TAYWOOD RD",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453221822",
            "telephone_number": "937-558-1256",
            "fax_number": "937-558-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 TAYWOOD RD",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453221822",
            "telephone_number": "937-558-1256",
            "fax_number": "937-558-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "ROBERT",
        "middle_name": "WRIGHTSMEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.