JACOB B FONDERLIN DC
NPI 1770414195
Chiropractor in Youngstown, OH

Q: What is Jacob Fonderlin's NPI number?

The NPI number for Jacob Fonderlin is 1770414195. It was assigned to this individual provider in the NPPES registry on May 26, 2026.

Q: What is Jacob Fonderlin's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Fonderlin was last updated on June 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 26, 2026

527 N MERIDIAN RD, YOUNGSTOWN, OH 44509(330) 797-0070(330) 797-9146 Get Directions Write a Review

NPPES record last updated: June 22, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Jacob B Fonderlin Dc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB B FONDERLIN DC (NPI 1770414195) is an individual chiropractor in Youngstown, Ohio, licensed in Ohio (DC-05554) and active in the NPI registry since May 2026. He maintains 3 additional practice locations and is a graduate of Other (2026).

NPPES Registry Identity

NPI1770414195

Entity TypeIndividualMale

Primary Taxonomy111N00000X

Provider Legal NameJACOB B FONDERLINCredential: DC

Location Address527 N MERIDIAN RDYoungstown, OH 44509-1227

Mailing Address527 N Meridian RdYoungstown, OH 44509-1227 · (330) 797-0070 · Fax (330) 797-9146

Phone(330) 797-0070

Fax(330) 797-9146

Sole ProprietorNo

Medical School CMSOtherGraduated 2026

Enumeration DateMay 26, 2026

Last NPPES UpdateJune 22, 2026

NPPES CertifiedJune 22, 2026

✔ NPI 1770414195 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in OH · DC-05554

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

527 N MERIDIAN RD, Youngstown, OH 44509

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Secondary Practice Locations 3

Location 18255 South AveYoungstown, OH 44512-6483 · Phone (330) 797-0070 · Fax (330) 797-9146

Location 2320 High St NEWarren, OH 44481-1222 · Phone (330) 797-0070 · Fax (330) 797-9146

Location 3550 W Chalmers AveYoungstown, OH 44511-1576 · Phone (330) 797-0070 · Fax (330) 797-9146

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob B Fonderlin Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8325512783

PECOS Enrollment IDI20260707002247

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EVELYN C CLARK LPCC-S

Counselor (Professional)