Individual provider Active NPI

Jacob Taylor Stiteler, D.C.

  • Chiropractor
  • New Smyrna Beach, FL
National Provider Identifier
1154513299
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3175 Issued in OH
Practice address
401 Canal St
New Smyrna Beach, FL 32168-7009
Phone
(724) 494-5815
NPI assigned
Aug 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 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 3175 OH Primary

Addresses

Primary practice location

401 Canal St
New Smyrna Beach, FL 32168-7009

Mailing address

401 Canal St
New Smyrna Beach, FL 32168-7009
Phone (724) 494-5815

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
3175OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Back 2 Health of the Ohio Valley Inc Chiropractor PastSince Jun 22, 2001 Accepting new patients

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": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1154513299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CANAL ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687009",
            "telephone_number": "724-494-5815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CANAL ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687009",
            "telephone_number": "724-494-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STITELER",
        "first_name": "JACOB",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.