W. RICHARD TEETERS, LLC NPI 1023295482

Clinic/Center (Medical Specialty) in Dayton, OH

NPI 1023295482 Organization Clinic/Center Medical Specialty

About W. RICHARD TEETERS, LLC

W. Richard Teeters, Llc is a provider established in Dayton, Ohio specializing in clinic/center (medical specialty) . The NPI number of W. Richard Teeters, Llc is 1023295482 and was assigned on January 2008. The practitioner's primary taxonomy code is 261QM2500X with license number 754 (OH). The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Richard Teeters D.c. (Owner Chiropractor)

NPI

1023295482

Provider NameW. RICHARD TEETERS, LLC
Provider Location Address1353 WOODMAN DR DAYTON, OH 45432
Provider Mailing Address1353 WOODMAN DR DAYTON, OH 45432
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Enumeration Date01-29-2008
Last Update Date06-24-2011


Primary Taxonomy

Taxonomy Code261QM2500X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationMedical Specialty
License No.754
License StateOH
Taxonomy DescriptionAn entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

Business Address

W. RICHARD TEETERS, LLC
1353 WOODMAN DR
DAYTON, OH
ZIP 45432
Phone: (937) 252-4400
Fax: (937) 252-4402

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Mailing Address

W. RICHARD TEETERS, LLC
1353 WOODMAN DR
DAYTON, OH
ZIP 45432
Phone: (937) 252-4400
Fax: (937) 252-4402



Authorized Official

Authorized Official Name RICHARD TEETERS D.C.
Authorized Official TitleOWNER CHIROPRACTOR
Authorized Official Phone(937) 252-4400

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
9256091MEDICARE PIN (08)OH
0981988MEDICAID (05)OH

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1568421972DR. W RICHARD TEETERS D.C.
Individual
Chiropractor1353 WOODMAN DR
DAYTON, OH 45432
(937) 252-4400
1619117090DR. WILLIAM NATHANIEL BAXTER D.C.
Individual
Chiropractor1353 WOODMAN DR
DAYTON, OH 45432
(937) 554-9582
1861452559DR. ERIC R BARKER D.C.
Individual
Chiropractor1353 WOODMAN DR
DAYTON, OH 45432
(937) 254-5480

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.