Individual provider Active NPI

John Lewis Gallaher IV, D.C.

  • Chiropractor
  • Newark, OH
National Provider Identifier
1811137177
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3961 Issued in OH
Practice address
919 N 21St St
Newark, OH 43055-2919
Phone
(740) 366-6601
Fax
(740) 366-6286
NPI assigned
Feb 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3961 OH Primary

Addresses

Primary practice location

919 N 21St St
Newark, OH 43055-2919

Mailing address

919 N 21St St
Newark, OH 43055-2919
Phone (740) 366-3139

Other identifiers 1

IdentifierTypeStateIssuer
3136446MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090413000036 OH Practitioner - Chiropractic 1557418464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

149 N High St
Hebron, OH 43025-9669
Phone (740) 928-7686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mantonya Chiropractic Center LLC Chiropractor CurrentSince May 1, 2016 Accepting new patients
Mantonya Chiropractic Center LLC Chiropractor CurrentSince May 1, 2016 Accepting new patients
Complete Chiropractic LLC Chiropractor PastSince Apr 1, 2002 Accepting new patients

Locations

149 N High St
Hebron, OH 43025
Phone (740) 928-7686

919 N 21st St
Newark, OH 43055
Phone (740) 366-3139

905 N 21st St
Ste D
Newark, OH 43055
Phone (740) 255-5189

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": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1811137177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 N 21ST ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552919",
            "telephone_number": "740-366-3139",
            "fax_number": "740-366-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 N 21ST ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552919",
            "telephone_number": "740-366-6601",
            "fax_number": "740-366-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAHER",
        "first_name": "JOHN",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-26",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3136446",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; 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.