Wynnslo Lydy, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC-04746 Issued in OH

Practice address

1329 County Line Rd
Crestline, OH 44827-4482

Phone

(419) 571-6151

NPI assigned

Aug 16, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Lydy Chiropractic, Inc.

  • Chiropractor
  • Crestline, OH
  • NPI 1073792628
  Medicare reassignment

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599955200000",
    "number": "1750807285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 COUNTY LINE RD",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "448271217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 COUNTY LINE RD",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "448274482",
            "telephone_number": "419-571-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYDY",
        "first_name": "WYNNSLO",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-16",
        "last_updated": "2020-09-13",
        "certification_date": "2020-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC-04746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mei Chiew Lai, M.D.
• Lane Drug Co
• Andrew John Lee, MD
• Ningchen Liu, MD
• Lydy Chiropractic, Inc.
• Sukhdeep Mann, RPH
• Connie Ann Martin, REGISTERED NURSE
• Ada Lynn Mason, LPN
• Kelly Jo McCartney, LPN
• Tracy McDaniel, ED.S

• Chiropractor in Crestline, OH
• Providers in Crestline, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2020; 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.