Individual provider Active NPI

Jasmine Perez, D.C.

  • Rehabilitation Chiropractor
  • Orange City, FL
National Provider Identifier
1144640863
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
CH11137 Issued in FL
Practice address
747 Fawn Ridge Dr Ste 100
Orange City, FL 32763-8268
Phone
(386) 259-9051
Fax
(386) 259-4243
NPI assigned
Apr 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X CH11137 FL Primary

Addresses

Primary practice location

747 Fawn Ridge Dr Ste 100
Orange City, FL 32763-8268

Mailing address

747 Fawn Ridge Dr Ste 100
Orange City, FL 32763-8268
Phone (386) 259-9051

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

LicenseStateTypeSpecialty
CH11137FLMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Management LLC Chiropractor Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2312/brand/1/csg/1/fhir/r4

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": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1144640863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 FAWN RIDGE DR STE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638268",
            "telephone_number": "386-259-9051",
            "fax_number": "386-259-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 FAWN RIDGE DR STE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638268",
            "telephone_number": "386-259-9051",
            "fax_number": "386-259-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JASMINE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "FL",
            "license": "CH11137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; 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.