100 Chiro Ten SQ Fleming Island LLC
Organization Active NPI Chiropractor · Fleming Island, FL
NPI 1023701224 · NPPES record last updated Jun 1, 2023
Key facts
- NPI
- 1023701224
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- 100 CHIRO TEN SQ FLEMING ISLAND LLC
- Practice address
- 1605 County Road 220 Ste 165
Fleming Island, FL 32003-4910 - Phone
- (904) 712-3548
- NPI assigned
- Jun 1, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. Hannah Staples
- Title
- Owner
- Phone
- (989) 329-8613
Practitioners 2
-
Robert Lance Bridges, D.C.
-
William Lewis Bevis, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231220000048 | FL | Part B Supplier - Clinic/Group Practice | 1456701259 |
Receives reassigned benefits from 1 practitioner Practice locations: Fleming Island, FL |
National Provider Directory
Locations
1605 County Road 220
Ste 165
Orange Park, FL 32003
Phone (904) 425-9060
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
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
Other providers in Fleming Island, FL
- 100 Chiro Fleming Island PLLC
- 100 Chiro Martin Sanders PLLC
- 100 Chiro Rosado Martin PLLC
- 1St Class Behavioral Services LLC
- A Journi Within LLC
- A Sanctuary Wellness Center
- Danika Ackley
- Acme Psychiatry Services LLC
All providers in Fleming Island, FL · Chiropractor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.