NPIMap

Organization Active NPI

Payne Chiropractic Life Center PA

  • Chiropractor
  • Destin, FL
National Provider Identifier
1083633200
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0006929 Issued in FL
Legal business name
PAYNE CHIROPRACTIC LIFE CENTER PA
Practice address
4014 Commons Dr W
Unit 114
Destin, FL 32541-8423
Phone
(850) 654-8770
Fax
(850) 654-1056
NPI assigned
Jul 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

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

Authorized official

Name
Dr. Alan M Payne, D.C.NPI 1598933673
Title
Dr.
Phone
(850) 654-8770

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH0006929 FL Primary

Addresses

Primary practice location

4014 Commons Dr W
Unit 114
Destin, FL 32541-8423

Mailing address

4014 Commons Dr W
Unit 114
Destin, FL 32541-8423
Phone (850) 654-8770

Other names 1

  • Payne Chiropractic Wellness Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080619000603 FL Part B Supplier - Clinic/Group Practice 7113098062 Receives reassigned benefits from 3 practitioners
Practice locations: Destin, FL

National Provider Directory

National Provider Directory

Locations

4014 Commons Dr W
Destin, FL 32541

4014 Commons Dr W
Ste 114
Destin, FL 32541
Phone (850) 654-8770

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": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1083633200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 COMMONS DR W",
            "address_2": "UNIT 114",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418423",
            "telephone_number": "850-654-8770",
            "fax_number": "850-654-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 COMMONS DR W",
            "address_2": "UNIT 114",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418423",
            "telephone_number": "850-654-8770",
            "fax_number": "850-654-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAYNE CHIROPRACTIC LIFE CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "850-654-8770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0006929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Payne Chiropractic Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Destin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.