Individual provider Active NPI

Caitlin Stouffer, CH

  • Chiropractor
  • Palm Beach Gardens, FL
National Provider Identifier
1114438207
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12318 Issued in FL
Practice address
4371 Northlake Blvd # 203
Palm Beach Gardens, FL 33410-6253
Phone
(561) 775-4900
Fax
(561) 775-0003
NPI assigned
Oct 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12318 FL Primary

Addresses

Primary practice location

4371 Northlake Blvd # 203
Palm Beach Gardens, FL 33410-6253

Mailing address

4371 Northlake Blvd # 203
Palm Beach Gardens, FL 33410-6253
Phone (561) 775-4900

Other identifiers 2

IdentifierTypeStateIssuer
111NOOOOOXOtherFLTAXONOMY
CH12318OtherFLMEDICAL LICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190523002522 FL Practitioner - Chiropractic 2567705007 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Palm Beach Physicians & Urgent Care Inc CurrentSince Feb 17, 2020 Accepting new patients
Central Palm Beach Physicians & Urgent Care, Inc. CurrentSince Feb 17, 2020 Accepting new patients
Basis Whole Body Wellness LLC Chiropractor Past Accepting new patients
Progressive Health and Wellness LLC Chiropractor Past Accepting new patients

Locations

6501 Congress Ave
Ste 350
Boca Raton, FL 33487
Phone (561) 981-8011

4623 Forest Hill Blvd
Ste 101
West Palm Beach, FL 33415
Phone (561) 966-7194

Organizations & group practices 4

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": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1114438207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 NORTHLAKE BLVD # 203",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334106253",
            "telephone_number": "561-775-4900",
            "fax_number": "561-775-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4371 NORTHLAKE BLVD # 203",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334106253",
            "telephone_number": "561-775-4900",
            "fax_number": "561-775-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUFFER",
        "first_name": "CAITLIN",
        "credential": "CH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "111NOOOOOX",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "CH12318",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; 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.