Individual provider Active NPI

Nicholas Manzanares, DC

  • Chiropractor
  • Bellbrook, OH
National Provider Identifier
1780337147
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-05155 Issued in OH
Practice address
4299 Sugarcreek Dr
Bellbrook, OH 45305-1330
Phone
(937) 848-8500
NPI assigned
Jan 26, 2022
Last updated
Jan 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-05155 OH Primary

Addresses

Primary practice location

4299 Sugarcreek Dr
Bellbrook, OH 45305-1330

Mailing address

2600 Falling Leaf CT
Fairborn, OH 45324-2688
Phone (850) 420-7643

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address manager@ihsp-oh.com

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DC-05155OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Health and Sports Performance, LLC Chiropractor CurrentSince Feb 1, 2022 Accepting new patients
Skyline Chiropractic Chiropractor Current Accepting new patients
Dr. Tyler T Lanning DC LLC Chiropractor PastSince Feb 1, 2022 Accepting new patients

Locations

4299 Sugarcreek Dr
Bellbrook, OH 45305
Phone (937) 848-8500

Interoperability endpoints

  • Direct secure messaging: manager@ihsp-oh.com

Organizations & group practices 3

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": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1780337147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 FALLING LEAF CT",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453242688",
            "telephone_number": "850-420-7643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4299 SUGARCREEK DR",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453051330",
            "telephone_number": "937-848-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZANARES",
        "first_name": "NICHOLAS",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC-05155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "manager@ihsp-oh.com",
            "affiliation": "N",
            "endpointDescription": "website email",
            "address_1": "4299 Sugarcreek Dr",
            "city": "Bellbrook",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453051330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellbrook, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.