Individual provider Active NPI

David Traster, DC

  • Neurology Chiropractor
  • Delray Beach, FL
National Provider Identifier
1124416599
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
CHIR009377 Issued in GA
Practice address
15966 Laurel Creek Dr
Delray Beach, FL 33446-9556
Phone
(973) 600-4675
NPI assigned
Jan 7, 2015
Last updated
Oct 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X CHIR009377 GA Primary
Neurology Chiropractor 111NN0400X CH11740 FL

Addresses

Primary practice location

15966 Laurel Creek Dr
Delray Beach, FL 33446-9556

Mailing address

15966 Laurel Creek Dr
Delray Beach, FL 33446-9556
Phone (973) 600-4675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220408002010 FL Practitioner - ChiropracticPractitioner - Neurology 2860809407 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR009377GAMDNeurology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
The Neurologic Wellness Institute, LLC Neurology Current Accepting new patients
Illinois Neuro & Physical Rehabilitation LTD Past Accepting new patients

Locations

199 S Addison Rd
Ste 106
Wood Dale, IL 60191
Phone (630) 766-1552

Organizations & group practices 3

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": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1124416599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15966 LAUREL CREEK DR",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334469556",
            "telephone_number": "973-600-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15966 LAUREL CREEK DR",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334469556",
            "telephone_number": "973-600-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRASTER",
        "first_name": "DAVID",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-07",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "GA",
            "license": "CHIR009377",
            "primary": true
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "FL",
            "license": "CH11740",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.