Active NPI
David Allen Inderwiesen, DC
- Chiropractor
- Orlando, FL
National Provider Identifier
1154489326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH5802
- Practice address
- 12484 Lake Underhill Rd
Orlando, FL 32828-7100 - Phone
- (407) 281-0900
- Fax
- (407) 281-0900
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH5802 | FL | Primary |
Addresses
Primary practice location
12484 Lake Underhill Rd
Orlando, FL 32828-7100
Mailing address
11905 E Colonial Drive
Orlando, FL 32826-4725
Phone (407) 281-0900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 381458100 | Medicaid | FL | |
| 22661 | Other | FL | BCBS OF FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CH5802 | FL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445212800000",
"number": "1154489326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11905 E COLONIAL DRIVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328264725",
"telephone_number": "407-281-0900",
"fax_number": "407-281-0900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12484 LAKE UNDERHILL RD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328287100",
"telephone_number": "407-281-0900",
"fax_number": "407-281-0900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INDERWIESEN",
"first_name": "DAVID",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2015-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH5802",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "381458100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF FL",
"identifier": "22661",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.