Organization Active NPI

Sambursky Chiropractic LLC

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1073740189
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9687 Issued in FL
Legal business name
SAMBURSKY CHIROPRACTIC LLC
Practice address
12412 San Jose Blvd
203
Jacksonville, FL 32223-8621
Phone
(904) 683-4376
NPI assigned
Jun 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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

Authorized official

Name
Bruce S Sambursky, DC
Title
Owner
Phone
(904) 683-4376

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH9687 FL Primary

Addresses

Primary practice location

12412 San Jose Blvd
203
Jacksonville, FL 32223-8621

Mailing address

12412 San Jose Blvd
203
Jacksonville, FL 32223-8621
Phone (904) 683-4376

National Provider Directory

National Provider Directory

Locations

12627 San Jose Blvd
Ste 305
Jacksonville, FL 32223
Phone (904) 683-4376

12421 San Jose Blvd
Ste 300
Jacksonville, FL 32223
Phone (904) 619-8430

12412 San Jose Blvd
Ste 203
Jacksonville, FL 32223
Phone (904) 432-3321

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1073740189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12412 SAN JOSE BLVD",
            "address_2": "203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238621",
            "telephone_number": "904-683-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12412 SAN JOSE BLVD",
            "address_2": "203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238621",
            "telephone_number": "904-683-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMBURSKY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "SAMBURSKY",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-683-4376",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.