NPIMap

Organization Active NPI

Healthsource of Northwest Florida LLC

  • Chiropractor
  • Pensacola, FL
National Provider Identifier
1104015866
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9112 Issued in FL
Legal business name
HEALTHSOURCE OF NORTHWEST FLORIDA LLC
Practice address
2122 W Nine Mile Rd
Pensacola, FL 32534-9464
Phone
(850) 473-5555
Fax
(850) 473-5505
NPI assigned
Oct 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Jason D Rabinowitz, DCNPI 1922087923
Title
Owner Chiropractor
Phone
(850) 473-5555

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CH7205 FL
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CH9112 FL Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CH11561 FL
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CH11826 FL
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CH12186 FL

Addresses

Primary practice location

2122 W Nine Mile Rd
Pensacola, FL 32534-9464

Mailing address

2122 W Nine Mile Rd
Pensacola, FL 32534-9464
Phone (850) 473-5555

Other practice location 1

4650 Woodbine Rd
Pace, FL 32571-8717
Phone (850) 995-5773

Other identifiers 1

IdentifierTypeStateIssuer
BM255AOtherFLMEDICARE PTAN

Other names 1

  • HEALTHSOURCE OF NW FLORIDA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090325000529 FL Part B Supplier - Clinic/Group Practice 0143387779 Receives reassigned benefits from 8 practitioners
Practice locations: Pace, FL; Pensacola, FL

National Provider Directory

National Provider Directory

Locations

4650 Woodbine Rd
Pace, FL 32571
Phone (850) 473-5555

2122 W Nine Mile Rd
Pensacola, FL 32534
Phone (850) 473-5555

1449 W Nine Mile Rd
Ste 5
Pensacola, FL 32534
Phone (850) 473-5555

Practitioners & affiliated clinicians

Practitioners 11

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": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1104015866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 W NINE MILE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325349464",
            "telephone_number": "850-473-5555",
            "fax_number": "850-473-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 W NINE MILE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325349464",
            "telephone_number": "850-473-5555",
            "fax_number": "850-473-5505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4650 Woodbine Rd",
            "address_purpose": "LOCATION",
            "city": "Pace",
            "state": "FL",
            "postal_code": "325718717",
            "country_code": "US",
            "telephone_number": "850-995-5773",
            "fax_number": "850-995-5713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEALTHSOURCE OF NORTHWEST FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RABINOWITZ",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER CHIROPRACTOR",
        "authorized_official_telephone_number": "850-473-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7205",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9112",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11561",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11826",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12186",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BM255A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTHSOURCE OF NW FLORIDA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.