Woodville Professional Healthcare LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2805 Issued in OH

Legal business name

WOODVILLE PROFESSIONAL HEALTHCARE LLC

Doing business as

Fremont Chiropractic Clinic

Practice address

444 N Stone St
Fremont, OH 43420-1530

Phone

(419) 334-7737

Fax

(419) 334-2828

NPI assigned

Dec 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ty N Tracy, DCNPI 1326060666

Title

Owner

Phone

(419) 334-7737

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fremont Chiropractic Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ty N Tracy, DC

  • Chiropractor
  • Fremont, OH
  • NPI 1326060666
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1780866525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 N STONE ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434201530",
            "telephone_number": "419-334-7737",
            "fax_number": "419-334-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N STONE ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434201530",
            "telephone_number": "419-334-7737",
            "fax_number": "419-334-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODVILLE PROFESSIONAL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "TRACY",
        "authorized_official_first_name": "TY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-334-7737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000362532",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fremont Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fremont Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Wodrich
• Luann R Wolf, CNP
• Women Caring for Women LLC
• Women'S Medical Center, Inc.
• Mary B. Wonderly, M.D.
• Yanke Bionics Inc
• Kimberly R Young, LMT
• Marissa Yzaugirre
• Beverly Ann Zywiczynsi, LPTA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.