Individual provider Active NPI

Andrew Ryan Canavan, D.C.

  • Chiropractor
  • Rockledge, FL
National Provider Identifier
1093051815
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10643 Issued in FL
Practice address
984 Rockledge Blvd
Rockledge, FL 32955-2128
Phone
(321) 636-6090
Fax
(321) 632-5805
NPI assigned
Dec 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH10643 FL Primary

Addresses

Primary practice location

984 Rockledge Blvd
Rockledge, FL 32955-2128

Mailing address

984 Rockledge Blvd
Rockledge, FL 32955-2128
Phone (321) 636-6090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130221000203 FL Practitioner - Chiropractic 0941455067 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

984 Rockledge Blvd
Rockledge, FL 32955-2128
Phone (321) 636-6090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH10643FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cocoa Chiropractic Center, PA Chiropractor CurrentSince Jun 15, 2019 Accepting new patients
Watt Family Chiropractic LLC Chiropractor CurrentSince Feb 19, 2013 Accepting new patients

Locations

111 N Fiske Blvd
Cocoa, FL 32922
Phone (321) 636-6090

2255 N Wickham Rd
Ste 109
Melbourne, FL 32935
Phone (321) 253-8511

984 Rockledge Blvd
Rockledge, FL 32955

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1356480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1093051815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984 ROCKLEDGE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552128",
            "telephone_number": "321-636-6090",
            "fax_number": "321-632-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 ROCKLEDGE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552128",
            "telephone_number": "321-636-6090",
            "fax_number": "321-632-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANAVAN",
        "first_name": "ANDREW",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-26",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.