Individual provider Active NPI

Gerald R Mattia, D.C.

  • Chiropractor
  • Orlando, FL
National Provider Identifier
1043374192
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH2832 Issued in FL
Practice address
8915 Conroy Windermere Rd
Orlando, FL 32835-3127
Phone
(407) 909-4788
Fax
(407) 909-1788
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH2832 FL Primary

Addresses

Primary practice location

8915 Conroy Windermere Rd
Orlando, FL 32835-3127

Mailing address

8915 Conroy Windermere Rd
Orlando, FL 32835-3127
Phone (407) 909-4788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Joint Regeneration and Rehabilitation Center LLC Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282608000000",
    "number": "1043374192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8915 CONROY WINDERMERE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328353127",
            "telephone_number": "407-909-4788",
            "fax_number": "407-909-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8915 CONROY WINDERMERE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328353127",
            "telephone_number": "407-909-4788",
            "fax_number": "407-909-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTIA",
        "first_name": "GERALD",
        "middle_name": "R",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2010-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH2832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; 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.