Edward Charles Siarkowicz, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH6640 Issued in FL

Practice address

4750 E Moody Blvd
#105
Bunnell, FL 32110-7709

Phone

(386) 437-2012

Fax

(386) 437-2191

NPI assigned

Sep 14, 2006

Last updated

Sep 1, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251763200000",
    "number": "1093810095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 E MOODY BLVD",
            "address_2": "#105",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321107709",
            "telephone_number": "386-437-2012",
            "fax_number": "386-437-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 E MOODY BLVD",
            "address_2": "#105",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321107709",
            "telephone_number": "386-437-2012",
            "fax_number": "386-437-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIARKOWICZ",
        "first_name": "EDWARD",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2009-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6640",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X007478",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Bunnell, FL
• Providers in Bunnell, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.