Organization Active NPI

Sickels Clinic of Chiropractic Inc

  • Chiropractor
  • Cocoa Beach, FL
National Provider Identifier
1033399878
Registry record updated Feb 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH5196 Issued in FL
Legal business name
SICKELS CLINIC OF CHIROPRACTIC INC
Practice address
503 N Orlando Ave
Suite 105
Cocoa Beach, FL 32931-3171
Phone
(321) 783-9400
Fax
(321) 783-9358
NPI assigned
Nov 9, 2007
Last updated
Feb 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2012

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

Authorized official

Name
Dr. Daniel Lewis Sickels, DCNPI 1871570671
Title
Owner/President
Phone
(321) 783-9400

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 CH5196 FL Primary

Addresses

Primary practice location

503 N Orlando Ave
Suite 105
Cocoa Beach, FL 32931-3171

Mailing address

503 N Orlando Ave
Suite 105
Cocoa Beach, FL 32931-3171
Phone (321) 783-9400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050822000324 FL Part B Supplier - Clinic/Group Practice 9537199385 Receives reassigned benefits from 1 practitioner
Practice locations: Cocoa Beach, FL

National Provider Directory

National Provider Directory

Locations

1980 N Atlantic Ave
Ste 330
Cocoa Beach, FL 32931
Phone (321) 610-8908

299 N Orlando Ave
Cocoa Beach, FL 32931
Phone (321) 783-5512

503 N Orlando Ave
Ste 105
Cocoa Beach, FL 32931
Phone (321) 783-9400

8057 Spyglass Hill Rd
Ste 104
Viera, FL 32940
Phone (321) 241-4877

Practitioners & affiliated clinicians

Practitioners 3

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": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328486400000",
    "number": "1033399878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 N ORLANDO AVE",
            "address_2": "SUITE 105",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313171",
            "telephone_number": "321-783-9400",
            "fax_number": "321-783-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 N ORLANDO AVE",
            "address_2": "SUITE 105",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313171",
            "telephone_number": "321-783-9400",
            "fax_number": "321-783-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SICKELS CLINIC OF CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2012-02-06",
        "status": "A",
        "authorized_official_last_name": "SICKELS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "321-783-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH5196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; 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.