Individual provider Active NPI

Eugene Glenn Neddo Jr., D.C.

  • Chiropractor
  • Cockeysville, MD
National Provider Identifier
1891091377
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03707 Issued in MD
Practice address
10153 York Rd Ste 105
Cockeysville, MD 21030-3398
Phone
(410) 628-2808
Fax
(410) 628-2818
NPI assigned
Feb 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S03707 MD Primary

Addresses

Primary practice location

10153 York Rd Ste 105
Cockeysville, MD 21030-3398

Mailing address

10153 York Rd Ste 105
Cockeysville, MD 21030-3398
Phone (410) 628-2808

Other practice location 1

530 Hook Rd
Westminster, MD 21157-5952
Phone (443) 834-8649

Other practice location 2

330 140 Village Rd Ste 9A
Westminster, MD 21157-6127
Phone (410) 876-8881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121116000259 MD Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 8820249014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Physical Medicine and Rehabilitation
Education
New York Chiropractic College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeffrey N Wallace DC PCGroup PAC ID 8628087327, 3 clinicians

Practice addresses (Care Compare)

330 140 Village Rd
Suite 9a
Westminster, MD 21157-6127
Phone (410) 876-8881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey N Wallace DC PC Chiropractor CurrentSince Oct 1, 2012 Accepting new patients
Scott L. Millison, D.C. PastSince Jan 16, 2018 Accepting new patients

Locations

330 140 Village Rd
Ste 9A
Westminster, MD 21157
Phone (410) 876-8881

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891091377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10153 YORK RD STE 105",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210303398",
            "telephone_number": "410-628-2808",
            "fax_number": "410-628-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10153 YORK RD STE 105",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210303398",
            "telephone_number": "410-628-2808",
            "fax_number": "410-628-2818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 Hook Rd",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "MD",
            "postal_code": "211575952",
            "country_code": "US",
            "telephone_number": "443-834-8649",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 140 Village Rd Ste 9A",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "MD",
            "postal_code": "211576127",
            "country_code": "US",
            "telephone_number": "410-876-8881",
            "fax_number": "410-848-6343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEDDO",
        "first_name": "EUGENE",
        "middle_name": "GLENN",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cockeysville, MD

Sources for this page

Verify at the official NPI Registry.