Ambrose S Perduk Jr DC Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1155 Issued in OH

Legal business name

AMBROSE S PERDUK JR DC INC

Practice address

125 W 2ND Street
Dover, OH 44622-2931

Phone

(330) 343-2621

Fax

(330) 343-6006

NPI assigned

May 10, 2007

Last updated

Jun 17, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ambrose S Perduk Jr., DCNPI 1619931250

Title

President

Phone

(330) 343-2621

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ambrose Steve Perduk Jr., DC

  • Chiropractor
  • Dover, OH
  • NPI 1619931250
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276732800000",
    "number": "1912112418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 W 2ND ST",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222931",
            "telephone_number": "330-343-2621",
            "fax_number": "330-343-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W 2ND STREET",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222931",
            "telephone_number": "330-343-2621",
            "fax_number": "330-343-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBROSE S PERDUK JR DC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2010-06-17",
        "status": "A",
        "authorized_official_last_name": "PERDUK",
        "authorized_official_first_name": "AMBROSE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-343-2621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0707668",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohammed Hassan Albahrani I
• Bethany Lynn Albaugh, APRN,PMHNP
• Alexis Albrecht
• Megan Allison, ATC, RN
• Tina Marie Alsept, CNP
• Wendy D Anderson I, RD, LD
• Andrew J. Wherley, M.D., LTD.
• Anesthesia Care of Union Hospital, Inc.
• Alyssa Rae Argentine, LSW
• Hayley Armstrong

• Chiropractor in Dover, OH
• Providers in Dover, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; 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.