Individual provider Active NPI

Michelle Lynn Gingras, D.C.

  • Chiropractor
  • South Daytona, FL
National Provider Identifier
1154438042
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8584 Issued in FL
Practice address
3113 S Ridgewood Ave
South Daytona, FL 32119-3547
Phone
(386) 767-6602
Fax
(386) 767-6602
NPI assigned
Aug 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH8584 FL Primary

Addresses

Primary practice location

3113 S Ridgewood Ave
South Daytona, FL 32119-3547

Mailing address

3113 S Ridgewood Ave
South Daytona, FL 32119-3547
Phone (386) 767-6602

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040102000065 FL Practitioner - Chiropractic 0042119778 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH8584FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Palmer College Foundation Chiropractor CurrentSince Feb 23, 2013 Accepting new patients
Palmer College Foundation Chiropractor CurrentSince Feb 23, 2013 Accepting new patients
Gingras Chiropractic Clinic PA Chiropractor PastSince Feb 23, 2013 Accepting new patients
Florida Coast Chiropractic Clinic Incorporated Chiropractor Past Accepting new patients

Locations

311 N Clyde Morris Blvd
Ste 310
Daytona Beach, FL 32114
Phone (386) 257-6644

4705 Clyde Morris Blvd
Pt Orange, FL 32129
Phone (386) 763-2712

1000 Brady St
Davenport, IA 52803
Phone (563) 884-5800

Organizations & group practices 4

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154438042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 S RIDGEWOOD AVE",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193547",
            "telephone_number": "386-767-6602",
            "fax_number": "386-767-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 S RIDGEWOOD AVE",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193547",
            "telephone_number": "386-767-6602",
            "fax_number": "386-767-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINGRAS",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.