Active NPI
John R Istad, D.C.
- Chiropractor
- Port Saint Lucie, FL
National Provider Identifier
1124160353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH6232
- Practice address
- 1105 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5332 - Phone
- (772) 398-5400
- Fax
- (772) 398-6600
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH6232 | FL | Primary |
Addresses
Primary practice location
1105 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5332
Mailing address
1105 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5332
Phone (772) 398-5400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6232 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282262400000",
"number": "1124160353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 SE PORT ST LUCIE BLVD",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349525332",
"telephone_number": "772-398-5400",
"fax_number": "772-398-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 SE PORT ST LUCIE BLVD",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349525332",
"telephone_number": "772-398-5400",
"fax_number": "772-398-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISTAD",
"first_name": "JOHN",
"middle_name": "R",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2010-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH6232",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.