Organization Active NPI

Flagler Chiropractic PA

  • Chiropractor
  • Flagler Beach, FL
National Provider Identifier
1073519864
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FLAGLER CHIROPRACTIC PA
Practice address
1240 South Aia
Flagler Beach, FL 32136
Phone
(386) 439-9001
Fax
(386) 439-9002
NPI assigned
Jun 27, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Sidi M Lemnouni, DCNPI 1942390323
Title
Chiropractic Physician
Phone
(386) 439-9001

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 FL Primary

Addresses

Primary practice location

1240 South Aia
Flagler Beach, FL 32136

Mailing address

1240 South Aia
Flagler Beach, FL 32136
Phone (386) 439-9001

Other identifiers 1

IdentifierTypeStateIssuer
22770OtherBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100105000046 FL Part B Supplier - Clinic/Group Practice 6002957685 Receives reassigned benefits from 1 practitioner
Practice locations: Flagler Beach, FL

National Provider Directory

National Provider Directory

Locations

1240 S Ocean Shore Blvd
Flagler Beach, FL 32136
Phone (386) 276-6163

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": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1073519864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 SOUTH AIA",
            "city": "FLAGLER BEACH",
            "state": "FL",
            "postal_code": "32136",
            "telephone_number": "386-439-9001",
            "fax_number": "386-439-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 SOUTH AIA",
            "city": "FLAGLER BEACH",
            "state": "FL",
            "postal_code": "32136",
            "telephone_number": "386-439-9001",
            "fax_number": "386-439-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLAGLER CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LEMNOUNI",
        "authorized_official_first_name": "SIDI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "386-439-9001",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "22770",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagler Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.