Individual provider Active NPI

John R Beltz, DC

  • Chiropractor
  • Ravenna, OH
National Provider Identifier
1790764629
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1837 Issued in OH
Practice address
821 W Main St
Ravenna, OH 44266-2705
Phone
(330) 296-9030
Fax
(330) 296-8003
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1837 OH Primary

Addresses

Primary practice location

821 W Main St
Ravenna, OH 44266-2705

Mailing address

821 W Main St
Ravenna, OH 44266-2705
Phone (330) 296-9030

Other identifiers 1

IdentifierTypeStateIssuer
0891012MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051102001035 OH Practitioner - Chiropractic 1658399209 Reassigns benefits to 1 organization
Practice locations: Ravenna, OH

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

821 W Main St
Ravenna, OH 44266-2705
Phone (330) 296-9030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1837OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Pain Management Specialists CurrentSince Dec 1, 2018 Accepting new patients
Comprehensive Pain Management Specialists CurrentSince Dec 1, 2018 Accepting new patients
A T Tamboli M D Inc Past Accepting new patients

Locations

2215 E Waterloo Rd
Ste 313
Akron, OH 44312
Phone (330) 208-2721

3535 S Smith Rd
Ste A
Fairlawn, OH 44333
Phone (330) 945-7246

1560 Corporate Woods Pkwy
Ste B
Green, OH 44685

1560 Corporate Woods Pkwy
Green, OH 44685
Phone 330208272011201

3051 Graham Rd
Stow, OH 44224
Phone (330) 673-1669

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1790764629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 W MAIN ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442662705",
            "telephone_number": "330-296-9030",
            "fax_number": "330-296-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 W MAIN ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442662705",
            "telephone_number": "330-296-9030",
            "fax_number": "330-296-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELTZ",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0891012",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravenna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.