NPIMap

Organization Active NPI

Fleming Island Family Chiropractic

  • Chiropractor
  • Orange Park, FL
National Provider Identifier
1154466217
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8049 Issued in FL
Legal business name
FLEMING ISLAND FAMILY CHIROPRACTIC
Practice address
1835 East West Parkway
Suite 3
Orange Park, FL 32003
Phone
(904) 264-3770
Fax
(904) 264-5885
NPI assigned
Feb 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kristen Thompson Burke, D.C.NPI 1972683670
Title
President
Phone
(904) 264-3770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH8049 FL Primary

Addresses

Primary practice location

1835 East West Parkway
Suite 3
Orange Park, FL 32003

Mailing address

1835 East West Parkway
Orange Park, FL 32003
Phone (904) 264-3770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070303000017 FL Part B Supplier - Clinic/Group Practice 0749382190 Receives reassigned benefits from 2 practitioners
Practice locations: Fleming Island, FL

National Provider Directory

National Provider Directory

Locations

1835 Eastwest Pkwy
Orange Park, FL 32003
Phone (904) 215-3958

1835 Eastwest Pkwy
Ste 3
Orange Park, FL 32003
Phone (904) 264-3770

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154466217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 EAST WEST PARKWAY",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32003",
            "telephone_number": "904-264-3770",
            "fax_number": "904-264-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 EAST WEST PARKWAY",
            "address_2": "SUITE 3",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32003",
            "telephone_number": "904-264-3770",
            "fax_number": "904-264-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLEMING ISLAND FAMILY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "THOMPSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-264-3770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.