Individual provider Active NPI

Jennifer Pamela Brandon, DC

  • Chiropractor
  • Cape Coral, FL
National Provider Identifier
1053493544
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 10987 Issued in FL
Practice address
618 SW 3Rd St
Cape Coral, FL 33991-1985
Phone
(239) 329-8987
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 10987 FL Primary
Chiropractor 111N00000X 720 VT

Addresses

Primary practice location

618 SW 3Rd St
Cape Coral, FL 33991-1985

Mailing address

618 SW 3Rd St
Cape Coral, FL 33991-1985
Phone (239) 329-8987

Other identifiers 2

IdentifierTypeStateIssuer
CH 10987OtherFLFL CHIROPRACTIC LICENSE
010227100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140211001126 FL Practitioner - Chiropractic 4981791472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

618 SW 3Rd St
Suite 117
Cape Coral, FL 33991-1995
Phone (239) 329-8987

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 10987FLMDChiropractor
720VTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Health in Focus: the Center for Chiropractic & Applied Kinesiology PLC Chiropractor CurrentSince Jan 26, 2011 Accepting new patients

Locations

2882 Shelburne Rd
Shelburne, VT 05482
Phone (802) 244-8877

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.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1053493544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 SW 3RD ST",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339911985",
            "telephone_number": "239-329-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 SW 3RD ST",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339911985",
            "telephone_number": "239-329-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "JENNIFER",
        "middle_name": "PAMELA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 10987",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VT",
            "license": "720",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL CHIROPRACTIC LICENSE",
            "identifier": "CH 10987",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010227100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.