Organization Active NPI

100 Chiro Fleming Island PLLC

  • Chiropractor
  • Fleming Island, FL
National Provider Identifier
1013868272
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
100 CHIRO FLEMING ISLAND PLLC
Practice address
1605 County Road 220 Ste 165
Fleming Island, FL 32003-4910
Phone
(904) 712-3548
Fax
(904) 712-3813
NPI assigned
Feb 4, 2026
Last updated
Mar 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Authorized official

Name
Robert Bridges, DCNPI 1487241030
Title
Owner
Phone
(904) 712-3548

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

1605 County Road 220 Ste 165
Fleming Island, FL 32003-4910

Mailing address

1605 County Road 220 Ste 165
Fleming Island, FL 32003-4910
Phone (904) 712-3548

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260310001264 FL Part B Supplier - Clinic/Group Practice 0042793952 Receives reassigned benefits from 1 practitioner
Practice locations: Fleming Island, FL

National Provider Directory

National Provider Directory

Locations

1605 County Road 220
Ste 165
Orange Park, FL 32003
Phone (904) 425-9060

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1770163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773100800000",
    "number": "1013868272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 COUNTY ROAD 220 STE 165",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034910",
            "telephone_number": "904-712-3548",
            "fax_number": "904-712-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 COUNTY ROAD 220 STE 165",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034910",
            "telephone_number": "904-712-3548",
            "fax_number": "904-712-3813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "100 CHIRO FLEMING ISLAND PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-04",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A",
        "authorized_official_last_name": "BRIDGES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-712-3548",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.