Individual provider Active NPI

Samantha Jo Lynette Staton, DC

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1124583885
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH14555 Issued in FL
Practice address
17429 Bridge Hill CT
Tampa, FL 33647-3467
Phone
(813) 983-7921
NPI assigned
Feb 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH14555 FL Primary

Addresses

Primary practice location

17429 Bridge Hill CT
Tampa, FL 33647-3467

Mailing address

28360 CR 280
Carrollton, MO 64633-8560
Phone (660) 322-1712

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241230000892 FL Practitioner - Chiropractic 8426585670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Tampa Spine and Joint Center LLCGroup PAC ID 2365581311, 4 clinicians

Practice addresses (Care Compare)

17429 Bridge Hill CT
Tampa, FL 33647-3467
Phone (813) 983-7921

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Tampa Spine & Joint Center LLC CurrentSince Sep 23, 2024 Accepting new patients

Locations

17429 Bridge Hill Ct
Tampa, FL 33647
Phone (813) 893-7921

Organizations & group practices 1

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": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1124583885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28360 CR 280",
            "city": "CARROLLTON",
            "state": "MO",
            "postal_code": "646338560",
            "telephone_number": "660-322-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17429 BRIDGE HILL CT",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473467",
            "telephone_number": "813-983-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATON",
        "first_name": "SAMANTHA JO",
        "middle_name": "LYNETTE",
        "name_prefix": "Miss",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-07",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.