Organization Active NPI

D'Amato Chiropractic Clinic Inc

  • Chiropractor
  • Youngstown, OH
National Provider Identifier
1770628695
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
879 Issued in OH
Legal business name
D'AMATO CHIROPRACTIC CLINIC INC
Practice address
841 Southwestern Run
Suite 2
Youngstown, OH 44514-3688
Phone
(330) 629-9292
Fax
(330) 629-9339
NPI assigned
Feb 20, 2007
Last updated
Mar 31, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Authorized official

Name
Dr. Adrian A D'Amato, D.C.NPI 1043350739
Title
Owner
Phone
(330) 629-9292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 879 OH Primary

Addresses

Primary practice location

841 Southwestern Run
Suite 2
Youngstown, OH 44514-3688

Mailing address

841 Southwestern Run
Suite 2
Poland, OH 44514-3671
Phone (330) 629-9292

Other identifiers 5

IdentifierTypeStateIssuer
000000136265OtherANTHEM
262210080002OtherOHMEDICAL MUTUAL
9389701OtherMEDICARE
262210080-00OtherOHWORKER'S COMPENSATION
3055241MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100803000448 OH Part B Supplier - Clinic/Group Practice 0941333504 Receives reassigned benefits from 1 practitioner
Practice locations: Poland, OH

National Provider Directory

National Provider Directory

Locations

841 Southwestern Run
Ste 2
Youngstown, OH 44514
Phone (330) 629-9292

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1770628695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 SOUTHWESTERN RUN",
            "address_2": "SUITE 2",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143671",
            "telephone_number": "330-629-9292",
            "fax_number": "330-629-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 SOUTHWESTERN RUN",
            "address_2": "SUITE 2",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445143688",
            "telephone_number": "330-629-9292",
            "fax_number": "330-629-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D'AMATO CHIROPRACTIC CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "D'AMATO",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-629-9292",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000136265",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL",
            "identifier": "262210080002",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "9389701",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMPENSATION",
            "identifier": "262210080-00",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3055241",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.