Individual provider Active NPI

Jennifer Jane Panchur, D.C.

  • Chiropractor
  • Wadsworth, OH
National Provider Identifier
1699820480
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2742 Issued in OH
Practice address
1197 High St
Suite 102
Wadsworth, OH 44281-8282
Phone
(330) 335-6070
Fax
(330) 335-6080
NPI assigned
Jan 24, 2007
Last updated
Aug 14, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 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 2742 OH Primary

Addresses

Primary practice location

1197 High St
Suite 102
Wadsworth, OH 44281-8282

Mailing address

1197 High St
Suite 102
Wadsworth, OH 44281-8282
Phone (330) 335-6070

Other identifiers 1

IdentifierTypeStateIssuer
2106876MedicaidOH

Other names 1

  • Dr. Jennifer Jane Priebe-Panchur Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050427000341 OH Practitioner - Chiropractic 3678512928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

805 E Washington St
Suite 100
Medina, OH 44256-3331
Phone (330) 335-6070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2742OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Minorik Chiropractic Center Chiropractor Past Accepting new patients
Minorik Health and Wellness Center Inc PastSince Feb 25, 2016 Accepting new patients

Organizations & group practices 3

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1699820480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1197 HIGH ST",
            "address_2": "SUITE 102",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818282",
            "telephone_number": "330-335-6070",
            "fax_number": "330-335-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1197 HIGH ST",
            "address_2": "SUITE 102",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818282",
            "telephone_number": "330-335-6070",
            "fax_number": "330-335-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCHUR",
        "first_name": "JENNIFER",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2106876",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PRIEBE-PANCHUR",
            "middle_name": "JANE",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wadsworth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.