NPIMap

Organization Active NPI

Streetsboro Chiropractic Clinic

  • Chiropractor
  • Streetsboro, OH
National Provider Identifier
1821030297
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
907 Issued in OH
Legal business name
STREETSBORO CHIROPRACTIC CLINIC
Practice address
9125 State Route 14
Streetsboro, OH 44241-5629
Phone
(330) 626-5561
Fax
(330) 626-9219
NPI assigned
Jun 12, 2006
Last updated
Oct 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Authorized official

Name
Dr. Gary L Wheat, DCNPI 1215963079
Title
Owner
Phone
(330) 626-5561

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 907 OH Primary

Addresses

Primary practice location

9125 State Route 14
Streetsboro, OH 44241-5629

Mailing address

PO Box 2067
Streetsboro, OH 44241-0067
Phone (330) 626-5561

Other identifiers 1

IdentifierTypeStateIssuer
0473232MedicaidOH

National Provider Directory

National Provider Directory

Locations

9125 State Route 14
Streetsboro, OH 44241
Phone (330) 626-5561

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1821030297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2067",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442410067",
            "telephone_number": "330-626-5561",
            "fax_number": "330-626-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9125 STATE ROUTE 14",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415629",
            "telephone_number": "330-626-5561",
            "fax_number": "330-626-9219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STREETSBORO CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "WHEAT",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-626-5561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0473232",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Streetsboro, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; 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.