Jacob Goldberg

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH13953 Issued in FL

Practice address

11012 N Dale Mabry Hwy Ste 304
Tampa, FL 33618-3821

Phone

(813) 563-7600

Fax

(813) 563-7601

NPI assigned

Apr 4, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Redefine Your Spine LLC

  • Chiropractor
  • Tampa, FL
  • NPI 1174250070
  Medicare reassignment NPD Authorized official
• Batesville Spine and Health Solutions LTD

  • General Practice Physician
  • Batesville, AR
  • NPI 1144620683

  Single Specialty

  NPD (past)
• Integrated Health Management Services, Inc

  • Rehabilitation Chiropractor
  • Batesville, AR
  • NPI 1730691072
  NPD (past)

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1043716459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11012 N DALE MABRY HWY STE 304",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336183821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11012 N DALE MABRY HWY STE 304",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336183821",
            "telephone_number": "813-563-7600",
            "fax_number": "813-563-7601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Harrison St Ste A",
            "address_purpose": "LOCATION",
            "city": "Batesville",
            "state": "AR",
            "postal_code": "725016949",
            "country_code": "US",
            "telephone_number": "870-569-4909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "JACOB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "CHD",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "address_1": "11012 N Dale Mabry Hwy Ste 304",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336183821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jake Gold, MD
• Jenifer Gold, M.S.
• Tanya T Gold, M.D.
• Michael Charles Goldbach, M.D.
• Dean Robert Goldberg, DO
• Lisa D Goldberg, PHD
• Richard Ian Goldberger, M.D.
• Golden Age Alf of Tampa Bay, Inc.
• Golden Age Home Care LLC
• Golden Bay Car Service

• Chiropractor in Tampa, FL
• Providers in Tampa, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.

Verify at the official NPI Registry.