Active NPI
Dustin J. Detrick, D.C., L.C.P.
- Chiropractor
- Fort Loramie, OH
National Provider Identifier
1699840512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2482
- Practice address
- 406 South Main Street
Fort Loramie, OH 45845 - Phone
- (937) 420-4000
- Fax
- (937) 420-4001
- NPI assigned
- Nov 24, 2006
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2482 | OH | Primary |
Addresses
Primary practice location
406 South Main Street
Fort Loramie, OH 45845
Mailing address
21 Miami Street
Fort Loramie, OH 45845
Phone (937) 420-2500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2482 | OH | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Huffer Chiropractic, Inc. | Chiropractor | Past | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | 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.
-
- Chiropractor
- Fort Loramie, OH
- NPI 1841464088
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1699840512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 MIAMI STREET",
"city": "FORT LORAMIE",
"state": "OH",
"postal_code": "45845",
"telephone_number": "937-420-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406 SOUTH MAIN STREET",
"city": "FORT LORAMIE",
"state": "OH",
"postal_code": "45845",
"telephone_number": "937-420-4000",
"fax_number": "937-420-4001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETRICK",
"first_name": "DUSTIN",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "D.C., L.C.P.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-24",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OH",
"license": "2482",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Loramie, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.