NPIMap

Organization Active NPI

Bluechip Initiative Inc

  • Rehabilitation Chiropractor
  • Ravenna, OH
National Provider Identifier
1891908539
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
3483 Issued in OH
Legal business name
BLUECHIP INITIATIVE INC
Practice address
6693 N Chestnut St
128
Ravenna, OH 44266-3922
Phone
(330) 297-9797
Fax
(330) 296-2329
NPI assigned
May 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Authorized official

Name
Dr. William Dustin Blueter, D.C.NPI 1629186101
Title
Owner
Phone
(330) 297-9797

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X 3483 OH Primary

Addresses

Primary practice location

6693 N Chestnut St
128
Ravenna, OH 44266-3922

Mailing address

6693 N Chestnut St
128
Ravenna, OH 44266-3922
Phone (330) 297-9797

Other identifiers 1

IdentifierTypeStateIssuer
2672728MedicaidOH

Other names 1

  • Ravenna Chiropractic & Acupuncture Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090406000098 OH Part B Supplier - Clinic/Group Practice 7315937760 Receives reassigned benefits from 4 practitioners
Practice locations: Ravenna, OH

National Provider Directory

National Provider Directory

Locations

6693 N Chestnut St
Ste 128
Ravenna, OH 44266
Phone (330) 297-9797

Practitioners & affiliated clinicians

Practitioners 5

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": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1891908539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6693 N CHESTNUT ST",
            "address_2": "128",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663922",
            "telephone_number": "330-297-9797",
            "fax_number": "330-296-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6693 N CHESTNUT ST",
            "address_2": "128",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663922",
            "telephone_number": "330-297-9797",
            "fax_number": "330-296-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUECHIP INITIATIVE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "BLUETER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-297-9797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "OH",
            "license": "3483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2672728",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ravenna Chiropractic & Acupuncture",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ravenna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; 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.