Individual provider Active NPI

Denise M. Carradine, D.C.

  • Chiropractor
  • Boardman, OH
National Provider Identifier
1962430140
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1894 Issued in OH
Practice address
8261 Market St
Suite a
Boardman, OH 44512-6254
Phone
(330) 758-4446
Fax
(330) 758-5703
NPI assigned
Jun 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1894 OH Primary

Addresses

Primary practice location

8261 Market St
Suite a
Boardman, OH 44512-6254

Mailing address

8286 South Ave B
Boardman, OH 44512-6415
Phone (330) 758-4446

Other identifiers 1

IdentifierTypeStateIssuer
0917155MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120509000225 OH Practitioner - Chiropractic 9739124181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carradine Chiropractic Center, Inc.Group PAC ID 5193760544, 2 clinicians

Practice addresses (Care Compare)

8286 S Ave
B
Boardman, OH 44512-6435
Phone (330) 758-4446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1894OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Carradine Chiropractic Center, Inc. Chiropractor CurrentSince Jan 1, 1998 Accepting new patients

Locations

8286 South Ave
Bldg B
Boardman, OH 44512
Phone (440) 384-7821

8286 South Ave
#B
Youngstown, OH 44512
Phone (330) 758-4446

8261 Market St
Ste A
Youngstown, OH 44512
Phone (330) 758-4446

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1962430140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8286 SOUTH AVE B",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126415",
            "telephone_number": "330-758-4446",
            "fax_number": "330-758-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8261 MARKET ST",
            "address_2": "SUITE A",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126254",
            "telephone_number": "330-758-4446",
            "fax_number": "330-758-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRADINE",
        "first_name": "DENISE",
        "middle_name": "M.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0917155",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; 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.