First Coast Spine, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

FIRST COAST SPINE, INC.

Practice address

4849 French St Ste 1
Jacksonville, FL 32205-5003

Phone

(904) 600-3426

Fax

(904) 800-1432

NPI assigned

Oct 25, 2014

Organization subpart

No

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

Authorized official

Name

Colt Mitchell AndreaNPI 1023305505

Title

President

Phone

(904) 600-3426

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Colt Mitchell Andrea, D.C.

  • Chiropractor
  • Jacksonville, FL
  • NPI 1023305505
  NPD Authorized official

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

{
    "created_epoch": "1414195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637712000000",
    "number": "1144625724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 MOSLEY RD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 FRENCH ST STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322055003",
            "telephone_number": "904-600-3426",
            "fax_number": "904-800-1432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST SPINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-25",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A",
        "authorized_official_last_name": "ANDREA",
        "authorized_official_first_name": "COLT",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-600-3426"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10319",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Coast Podiatric Surgery and Wound Care LLC
• First Coast Podiatry, P a
• First Coast Primary Care Inc
• First Coast Retina Center PA
• First Coast Speech Services, LLC
• First Coast Surgical Associates Inc
• First Coast TMS, PLLC
• First Coast Transport Services LLC
• First Coast Vision Care PA
• First Fruit Home Care LLC

• Chiropractor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.