Active NPI
Shaun Paul Janse Van Rensburg, D.C.
- Chiropractor
- Orange Park, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH11443
- Practice address
- 2300 Park Ave Ste 206
Orange Park, FL 32073-5573 - Phone
- (904) 634-0640
- Fax
- (904) 634-0203
- NPI assigned
- Jul 20, 2015
- Last updated
- Nov 12, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH11443 | FL | Primary |
Addresses
Primary practice location
2300 Park Ave Ste 206
Orange Park, FL 32073-5573
Mailing address
6800 Southpoint Pkwy Ste 300
Jacksonville, FL 32216-8203
Phone (904) 634-0640
Other practice location 1
2627 Riverside Ave
3rd Floor
Jacksonville, FL 32204-4712
Phone (904) 634-0640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108060500 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2627 Riverside Ave
FL 3
Jacksonville, FL 32204-4717
Phone (904) 634-0640
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.75 of 100
- Quality
- 88.19
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 80.96
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Orthopedic Specialists, LLC | Current | Accepting new patients | |
| Southeast Orthopedic Specialists, LLC | Current | Accepting new patients |
Locations
4565 US Highway 17
Ste 200
Fleming Island, FL 32003
Phone (904) 630-0640
10475 Centurion Pkwy N
Ste 220
Jacksonville, FL 32256
Phone 9046340640 ext. 1014
15255 Max Leggett Pkwy
Ste 5300
Jacksonville, FL 32218
Phone (904) 203-1386
2627 Riverside Ave
Fl 3
Jacksonville, FL 32204
Phone 9046340640 ext. 1014
2627 Riverside Ave
Ste 300
Jacksonville, FL 32204
Phone (904) 634-0460
6500 Bowden Rd
Ste 103
Jacksonville, FL 32216
6800 Southpoint Pkwy
Ste 300
Jacksonville, FL 32216
2300 Park Ave
Ste 206
Orange Park, FL 32073
Phone (904) 278-4274
232 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082
Phone (904) 285-7546
1690 US Highway 1 S
Ste F
St Augustine Beach, FL 32084
Phone (904) 634-0460
Networks
- FL PPO
Interoperability endpoints
- shaun.janse.van.rensburg.1@22724.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- Jacksonville, FL
- NPI 1629025820
-
- Durable Medical Equipment & Medical Supplies
- Saint Johns, FL
- NPI 1538952379
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762905600000",
"number": "1023493079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 SOUTHPOINT PKWY STE 300",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322168203",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 PARK AVE STE 206",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320735573",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203"
}
],
"practiceLocations": [
{
"address_1": "2627 Riverside Ave",
"address_2": "3rd Floor",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322044712",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JANSE VAN RENSBURG",
"first_name": "SHAUN",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-20",
"last_updated": "2025-11-12",
"certification_date": "2025-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH11443",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "108060500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.