Individual provider Active NPI

Shad Alan Foster, D.C.

  • Chiropractor
  • Van Wert, OH
National Provider Identifier
1750493375
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2440 Issued in OH
Practice address
10963 Van Wert Decatur Rd
Van Wert, OH 45891-9211
Phone
(419) 238-6686
Fax
(419) 238-6201
NPI assigned
Aug 31, 2006
Last updated
May 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2440 OH Primary
Chiropractor 111N00000X 08002137A IN

Addresses

Primary practice location

10963 Van Wert Decatur Rd
Van Wert, OH 45891-9211

Mailing address

10963 Van Wert Decatur Rd
Van Wert, OH 45891-9211
Phone (419) 238-6686

Other identifiers 4

IdentifierTypeStateIssuer
9312811OtherOHPTAN
H536770OtherOHGROUP PTAN
H536771OtherOHINDIVIDUAL PTAN
2527573MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170508001879 OH Practitioner - Chiropractic 3971404971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fuerst Family Chiropractic, LLCGroup PAC ID 4385036037, 3 clinicians

Practice addresses (Care Compare)

10963 Van Wert Decatur Rd
Van Wert, OH 45891-9211
Phone 4192386686110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08002137AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fuerst Family Chiropractic, LLC Chiropractor CurrentSince Feb 15, 2022 Accepting new patients
Total Body Chiropractic Center, LLC Chiropractor PastSince Nov 1, 2006 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Ft Recovery Chiropractic, LLC Chiropractor Past Accepting new patients
Back to Health, LLC Chiropractor PastSince Mar 2, 2005 Accepting new patients
Bultemeyer Chiropractic, LLC Chiropractor PastSince Jan 9, 2015 Accepting new patients

Locations

10963 Van Wert Decatur Rd
Van Wert, OH 45891
Phone (419) 238-6686

Organizations & group practices 7

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1750493375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10963 VAN WERT DECATUR RD",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458919211",
            "telephone_number": "419-238-6686",
            "fax_number": "419-238-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10963 VAN WERT DECATUR RD",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458919211",
            "telephone_number": "419-238-6686",
            "fax_number": "419-238-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "SHAD",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2440",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002137A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "9312811",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "H536770",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN",
            "identifier": "H536771",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2527573",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Wert, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.