Individual provider Active NPI

Amy Mae Varckette, DC

  • Chiropractor
  • Ashtabula, OH
National Provider Identifier
1750198362
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-05408 Issued in OH
Practice address
1956 W Prospect Rd
Ashtabula, OH 44004-6424
Phone
(440) 992-0160
Fax
(440) 998-0121
NPI assigned
Dec 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-05408 OH Primary

Addresses

Primary practice location

1956 W Prospect Rd
Ashtabula, OH 44004-6424

Mailing address

5013 State Route 307 E
Geneva, OH 44041-9616
Phone (440) 415-3817

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250207000947 OH Practitioner - Chiropractic 4880124700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas D Disalvatore DC IncGroup PAC ID 9830086974, 2 clinicians

Practice addresses (Care Compare)

1956 W Prospect Rd
Ashtabula, OH 44004-6424
Phone (440) 992-0160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-05408OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas D. Disalvatore, D.C., Inc. Chiropractor CurrentSince Jan 6, 2025 Accepting new patients

Locations

1956 W Prospect Rd
Ashtabula, OH 44004
Phone (440) 536-2339

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": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1750198362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5013 STATE ROUTE 307 E",
            "city": "GENEVA",
            "state": "OH",
            "postal_code": "440419616",
            "telephone_number": "440-415-3817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1956 W PROSPECT RD",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046424",
            "telephone_number": "440-992-0160",
            "fax_number": "440-998-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARCKETTE",
        "first_name": "AMY",
        "middle_name": "MAE",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC-05408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.