Individual provider Active NPI

Michael Kevin Monroe, DC

  • Chiropractor
  • West Jefferson, OH
National Provider Identifier
1871595595
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1750 Issued in OH
Practice address
25 Inwood Rd
West Jefferson, OH 43162-1112
Phone
(614) 879-5070
Fax
(614) 879-5023
NPI assigned
Aug 12, 2005
Last updated
Sep 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1750 OH Primary

Addresses

Primary practice location

25 Inwood Rd
West Jefferson, OH 43162-1112

Mailing address

25 Inwood Rd
West Jefferson, OH 43162-1112
Phone (614) 879-5070

Other identifiers 4

IdentifierTypeStateIssuer
44-00105OtherUNITED HEALTH CARE #
000000119775OtherANTHEM BC/BS
1750OtherOHSTATE LICENSE #
0855436MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111206000855 OH Practitioner - Chiropractic 2466540109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Krichael CorporationGroup PAC ID 7517989874, 2 clinicians

Practice addresses (Care Compare)

25 Inwood Rd
West Jefferson, OH 43162-1112
Phone (614) 879-5070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1750OHMDChiropractor

Organizations & group practices 1

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1871595595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 INWOOD RD",
            "city": "WEST JEFFERSON",
            "state": "OH",
            "postal_code": "431621112",
            "telephone_number": "614-879-5070",
            "fax_number": "614-879-5023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 INWOOD RD",
            "city": "WEST JEFFERSON",
            "state": "OH",
            "postal_code": "431621112",
            "telephone_number": "614-879-5070",
            "fax_number": "614-879-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONROE",
        "first_name": "MICHAEL",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE #",
            "identifier": "44-00105",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000119775",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "1750",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0855436",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jefferson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.