Individual provider Active NPI

Adam P Mack, DC

  • Chiropractor
  • Brecksville, OH
National Provider Identifier
1851325450
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2863 Issued in OH
Practice address
8930 Brecksville Rd
Brecksville, OH 44141-2318
Phone
(440) 740-0696
Fax
(440) 740-0697
NPI assigned
Jul 10, 2006
Last updated
Feb 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2863 OH Primary

Addresses

Primary practice location

8930 Brecksville Rd
Brecksville, OH 44141-2318

Mailing address

8930 Brecksville Rd
Brecksville, OH 44141-2318
Phone (440) 740-0696

Other identifiers 1

IdentifierTypeStateIssuer
2328814MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100602000693 OH Practitioner - Chiropractic 1658400502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Health and Wellness Center of Ohio LLCGroup PAC ID 3274771217, 4 clinicians

Practice addresses (Care Compare)

8930 Brecksville Rd
Brecksville, OH 44141-2318
Phone (440) 740-0696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2863OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Health and Wellness Center of Ohio LLC CurrentSince Jan 2, 2014 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

8930 Brecksville Rd
Brecksville, OH 44141
Phone (440) 740-0696

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1851325450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8930 BRECKSVILLE RD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441412318",
            "telephone_number": "440-740-0696",
            "fax_number": "440-740-0697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8930 BRECKSVILLE RD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441412318",
            "telephone_number": "440-740-0696",
            "fax_number": "440-740-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "ADAM",
        "middle_name": "P",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2328814",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brecksville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.