Individual provider Active NPI

Harold Schubert Jr., D.C.

  • Chiropractor
  • Sidney, OH
National Provider Identifier
1760596548
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3364 Issued in OH
Practice address
1640 Gleason St
Sidney, OH 45365-3561
Phone
(937) 492-4681
Fax
(937) 492-7200
NPI assigned
Aug 18, 2006
Last updated
Mar 13, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3364 OH Primary

Addresses

Primary practice location

1640 Gleason St
Sidney, OH 45365-3561

Mailing address

1640 Gleason St
Sidney, OH 45365-3561
Phone (937) 492-4681

Other identifiers 2

IdentifierTypeStateIssuer
480195OtherOHANTHEM/PIN
2432228MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050920000171 OH Practitioner - ChiropracticPractitioner - Diagnostic Radiology 5890681225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Diagnostic Radiology
Education
Northwestern College of Chiropractic, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sidney Chiropractic IncGroup PAC ID 2769416866, 3 clinicians

Practice addresses (Care Compare)

1640 Gleason St
Sidney, OH 45365-3561
Phone (937) 492-4681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3364OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sidney Chiropractic, Inc. Chiropractor CurrentSince Sep 1, 2003 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1640 Gleason St
Sidney, OH 45365
Phone (937) 492-4681

Organizations & group practices 2

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1760596548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 GLEASON ST",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453653561",
            "telephone_number": "937-492-4681",
            "fax_number": "937-492-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 GLEASON ST",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453653561",
            "telephone_number": "937-492-4681",
            "fax_number": "937-492-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUBERT",
        "first_name": "HAROLD",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM/PIN",
            "identifier": "480195",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2432228",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, OH

Sources for this page

Verify at the official NPI Registry.