Active NPI
Jay B Riedel, D.C.
- Chiropractor
- Geneva, OH
National Provider Identifier
1760403273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3328
- Practice address
- 614 E Main St
Geneva, OH 44041-1385 - Phone
- (440) 466-1155
- Fax
- (440) 466-1255
- NPI assigned
- Jul 21, 2006
- 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 | 3328 | OH | Primary |
Addresses
Primary practice location
614 E Main St
Geneva, OH 44041-1385
Mailing address
614 E Main St
Geneva, OH 44041-1385
Phone (440) 466-1155
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00199838 | Other | OH | RAILROAD MEDICARE |
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 |
|---|---|---|---|
| 3328 | OH | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active Life Chiropractic Center | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- Geneva, OH
- NPI 1144247818
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760403273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "614 E MAIN ST",
"city": "GENEVA",
"state": "OH",
"postal_code": "440411385",
"telephone_number": "440-466-1155",
"fax_number": "440-466-1255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "614 E MAIN ST",
"city": "GENEVA",
"state": "OH",
"postal_code": "440411385",
"telephone_number": "440-466-1155",
"fax_number": "440-466-1255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIEDEL",
"first_name": "JAY",
"middle_name": "B",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OH",
"license": "3328",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00199838",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Geneva, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.