NPIMap

Organization Active NPI

Lifestyle Health Care Center

  • Chiropractor
  • St. Marys, OH
National Provider Identifier
1801065107
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1393 Issued in OH
Legal business name
LIFESTYLE HEALTH CARE CENTER
Practice address
1633 Celina Rd
St. Marys, OH 45885-1812
Phone
(419) 394-8194
NPI assigned
Feb 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Authorized official

Name
Scott Randal Bruce, D.C.NPI 1952453250
Title
President
Phone
(419) 394-8194

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1393 OH Primary

Addresses

Primary practice location

1633 Celina Rd
St. Marys, OH 45885-1812

Mailing address

PO Box 308
St. Marys, OH 45885-0308
Phone (419) 394-8194

Other identifiers 1

IdentifierTypeStateIssuer
0868744MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1801065107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "ST. MARYS",
            "state": "OH",
            "postal_code": "458850308",
            "telephone_number": "419-394-8194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 CELINA RD",
            "city": "ST. MARYS",
            "state": "OH",
            "postal_code": "458851812",
            "telephone_number": "419-394-8194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE HEALTH CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "BRUCE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "RANDAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-394-8194",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0868744",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Marys, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.