NPIMap

Organization Active NPI

Wolph Chiropractic, Inc.

  • Chiropractor
  • Fostoria, OH
National Provider Identifier
1841489044
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2342 Issued in OH
Legal business name
WOLPH CHIROPRACTIC, INC.
Practice address
123 S Main St
Fostoria, OH 44830-2309
Phone
(419) 436-0616
Fax
(419) 435-1622
NPI assigned
Oct 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Authorized official

Name
Dr. Clay W Wolph, D.C.NPI 1962425066
Title
Owner
Phone
(419) 436-0616

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 2342 OH Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 1859 OH

Addresses

Primary practice location

123 S Main St
Fostoria, OH 44830-2309

Mailing address

123 S Main St
Fostoria, OH 44830-2309
Phone (419) 436-0616

Other identifiers 2

IdentifierTypeStateIssuer
0888491MedicaidOH
0230539MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060331000579 OH Part B Supplier - Clinic/Group Practice 3678581600 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bowling Green, OH; Fostoria, OH

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Wolph Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

123 S Main St
Fostoria, OH 44830
Phone (419) 436-0616

Practitioners & affiliated clinicians

Practitioners 2

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": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1841489044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 S MAIN ST",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "448302309",
            "telephone_number": "419-436-0616",
            "fax_number": "419-435-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S MAIN ST",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "448302309",
            "telephone_number": "419-436-0616",
            "fax_number": "419-435-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLPH CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "WOLPH",
        "authorized_official_first_name": "CLAY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-436-0616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2342",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1859",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0888491",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0230539",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fostoria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.