NPIMap

Organization Active NPI

City of Palms Chiropractic LLC

  • Chiropractor
  • Fort Myers, FL
National Provider Identifier
1083039127
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10966 Issued in FL
Legal business name
CITY OF PALMS CHIROPRACTIC LLC
Practice address
11621 S Cleveland Ave
Unit 80
Fort Myers, FL 33907-2866
Phone
(239) 690-7794
NPI assigned
Feb 26, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Authorized official

Name
Dr. Ryan Scott Nickens, D.C.
Title
Owner/Ceo
Phone
(321) 615-7998

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH10966 FL Primary

Addresses

Primary practice location

11621 S Cleveland Ave
Unit 80
Fort Myers, FL 33907-2866

Mailing address

11621 S Cleveland Ave
Unit 80
Fort Myers, FL 33907-2866
Phone (239) 690-7794

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1083039127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11621 S CLEVELAND AVE",
            "address_2": "UNIT 80",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072866",
            "telephone_number": "239-690-7794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11621 S CLEVELAND AVE",
            "address_2": "UNIT 80",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072866",
            "telephone_number": "239-690-7794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF PALMS CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-26",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "NICKENS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "321-615-7998",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; 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.