Individual provider Active NPI

Joseph R Conigliaro, BS, DC, FACMUAP

  • Chiropractor
  • Fort Myers, FL
National Provider Identifier
1003896309
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH15113 Issued in FL
Practice address
12468 Brantley Commons CT
Fort Myers, FL 33907-5663
Phone
(239) 292-6920
NPI assigned
Jan 20, 2006
Last updated
Feb 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2018030044 MO
Chiropractor 111N00000X CH15113 FL Primary
Chiropractor 111N00000X 01-04718 KS

Addresses

Primary practice location

12468 Brantley Commons CT
Fort Myers, FL 33907-5663

Mailing address

2125 SE 18TH Ave
Cape Coral, FL 33990-4707
Phone (239) 292-6920

Other identifiers 6

IdentifierTypeStateIssuer
627731OtherUHC ACN
7682235OtherAETNA REFERRAL
902504OtherBCBS KS
2583399OtherAETNA PROVIDER
4400698OtherUHC
29483017OtherBCBS KC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
CH15113FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Valley Surgical Associates, LLC Current Accepting new patients
Joseph R Conigliaro, DC Chiropractor Past Accepting new patients
Gulf Coast Mua Physicians, LLC Chiropractor PastSince Feb 23, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: joseph.conigliaro.1@31266.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1003896309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 SE 18TH AVE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339904707",
            "telephone_number": "239-292-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12468 BRANTLEY COMMONS CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075663",
            "telephone_number": "239-292-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONIGLIARO",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "BS, DC, FACMUAP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2018030044",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH15113",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-04718",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC ACN",
            "identifier": "627731",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA REFERRAL",
            "identifier": "7682235",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KS",
            "identifier": "902504",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER",
            "identifier": "2583399",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "4400698",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "29483017",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.