Anthony James Wyrwas, DC DACBSP

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

3287 Issued in OH

Practice address

7575 Northcliff Avenue
Suite 405
Brooklyn, OH 44144

Phone

(216) 830-2225

Fax

(216) 830-2228

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1821156696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7575 NORTHCLIFF AVENUE",
            "address_2": "SUITE 405",
            "city": "BROOKLYN",
            "state": "OH",
            "postal_code": "44144",
            "telephone_number": "216-830-2225",
            "fax_number": "216-830-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 NORTHCLIFF AVENUE",
            "address_2": "SUITE 405",
            "city": "BROOKLYN",
            "state": "OH",
            "postal_code": "44144",
            "telephone_number": "216-830-2225",
            "fax_number": "216-830-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYRWAS",
        "first_name": "ANTHONY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DC DACBSP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3287",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OH",
            "license": "3287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.