Individual provider Active NPI

Roger A Wilhelm Jr., DC

  • Chiropractor
  • Rootstown, OH
National Provider Identifier
1992811061
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2880 Issued in OH
Practice address
4155 Tallmadge Rd
Rootstown, OH 44272
Phone
(330) 325-2575
Fax
(330) 325-2676
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2880 OH Primary

Addresses

Primary practice location

4155 Tallmadge Rd
Rootstown, OH 44272

Mailing address

4155 Tallmadge Rd
Rootstown, OH 44272
Phone (330) 325-2575

Other identifiers 1

IdentifierTypeStateIssuer
2256151MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080408000626 OH Practitioner - Chiropractic 3577640069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4155 Tallmadge Rd
Rootstown, OH 44272-9657
Phone (330) 325-2575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2880OHMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wilhelm Chiropractic Chiropractor CurrentSince Feb 1, 2001 Accepting new patients

Locations

4155 Tallmadge Rd
Rootstown, OH 44272
Phone (330) 325-2575

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1992811061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 TALLMADGE RD",
            "city": "ROOTSTOWN",
            "state": "OH",
            "postal_code": "44272",
            "telephone_number": "330-325-2575",
            "fax_number": "330-325-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 TALLMADGE RD",
            "city": "ROOTSTOWN",
            "state": "OH",
            "postal_code": "44272",
            "telephone_number": "330-325-2575",
            "fax_number": "330-325-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHELM",
        "first_name": "ROGER",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2256151",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rootstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.