Organization Active NPI

Thomas J. Kreusch, Jr. D.C. Inc.

  • Chiropractor
  • Wilmington, OH
National Provider Identifier
1700090263
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1057 Issued in OH
Legal business name
THOMAS J. KREUSCH, JR. D.C. INC.
Practice address
24 Randolph St Ste B
Wilmington, OH 45177-2786
Phone
(937) 382-1095
Fax
(937) 382-3739
NPI assigned
May 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Dr. Thomas John Kreusch Jr., D.C.
Title
President
Phone
(937) 382-1095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1057 OH Primary

Addresses

Primary practice location

24 Randolph St Ste B
Wilmington, OH 45177-2786

Mailing address

24 Randolph St Ste B
Wilmington, OH 45177-2786
Phone (937) 382-1095

Other identifiers 1

IdentifierTypeStateIssuer
0610717MedicaidOH

Other names 1

  • Kreusch Chiropractic Center Doing business as

National Provider Directory

National Provider Directory

Locations

24 Randolph St
Ste B
Wilmington, OH 45177
Phone (937) 382-1095

2333 Rombach Ave
Wilmington, OH 45177
Phone (937) 382-1095

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1700090263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 RANDOLPH ST STE B",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772786",
            "telephone_number": "937-382-1095",
            "fax_number": "937-382-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 RANDOLPH ST STE B",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772786",
            "telephone_number": "937-382-1095",
            "fax_number": "937-382-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS J. KREUSCH, JR. D.C. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "KREUSCH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-382-1095",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0610717",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kreusch Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.