NPIMap

Organization Active NPI

Maitland Chiropractic Clinic Inc

  • Chiropractor
  • Maitland, FL
National Provider Identifier
1023075181
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
HCC6175 Issued in FL
Legal business name
MAITLAND CHIROPRACTIC CLINIC INC
Practice address
500 S Maitland Ave
Maitland, FL 32751-5622
Phone
(407) 628-9999
Fax
(407) 628-2917
NPI assigned
May 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Authorized official

Name
Miss Christianne Michelle Duval
Title
Vice President
Phone
(407) 628-9999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X HCC6175 FL Primary

Addresses

Primary practice location

500 S Maitland Ave
Maitland, FL 32751-5622

Mailing address

500 S Maitland Ave
Maitland, FL 32751-5622
Phone (407) 628-9999

Other identifiers 1

IdentifierTypeStateIssuer
3817849 00MedicaidFL

National Provider Directory

National Provider Directory

Locations

500 S Maitland Ave
Maitland, FL 32751
Phone (407) 628-9999

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1023075181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S MAITLAND AVE",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515622",
            "telephone_number": "407-628-9999",
            "fax_number": "407-628-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S MAITLAND AVE",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515622",
            "telephone_number": "407-628-9999",
            "fax_number": "407-628-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAITLAND CHIROPRACTIC CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "DUVAL",
        "authorized_official_first_name": "CHRISTIANNE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "407-628-9999",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "HCC6175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3817849 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; 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.