Individual provider Active NPI

Nicole Kelly Cheyne, D.C.

  • Chiropractor
  • Fort Pierce, FL
National Provider Identifier
1114004314
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7337 Issued in FL
Practice address
5050 South 25TH Street
Fort Pierce, FL 34981-4923
Phone
(772) 468-8891
Fax
(772) 468-7929
NPI assigned
Nov 1, 2006
Last updated
Nov 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7337 FL Primary

Addresses

Primary practice location

5050 South 25TH Street
Fort Pierce, FL 34981-4923

Mailing address

5050 South 25TH Street
Fort Pierce, FL 34981-4923
Phone (772) 468-8891

Other names 1

  • Mrs. Nicole Renee Kelly Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060106000693 FL Practitioner - Chiropractic 5092738880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cheyne Family Chiropractic CentreGroup PAC ID 5193986149, 2 clinicians

Practice addresses (Care Compare)

5050 S 25TH St
Fort Pierce, FL 34981-4923
Phone (772) 468-8891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cheyne Family Chiropractic Centre Chiropractor CurrentSince Jul 1, 2012 Accepting new patients
William a. Olivos, OD, PA Past Accepting new patients

Locations

5050 S 25th St
Fort Pierce, FL 34981
Phone (772) 216-3634

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1114004314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SOUTH 25TH STREET",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349814923",
            "telephone_number": "772-468-8891",
            "fax_number": "772-468-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 SOUTH 25TH STREET",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349814923",
            "telephone_number": "772-468-8891",
            "fax_number": "772-468-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEYNE",
        "first_name": "NICOLE",
        "middle_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "KELLY",
            "middle_name": "RENEE",
            "prefix": "MRS.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.