Individual provider Active NPI

Riley Sean Dodd, DC

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1154959716
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH13110 Issued in FL
Practice address
2025 Park St
Jacksonville, FL 32204-3809
Phone
(904) 388-1811
NPI assigned
Mar 30, 2020
Last updated
Mar 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH13110 FL Primary

Addresses

Primary practice location

2025 Park St
Jacksonville, FL 32204-3809

Mailing address

2025 Park St
Jacksonville, FL 32204-3809
Phone (904) 388-1811

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200409003052 FL Practitioner - Chiropractic 5890124994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dodd Chiropractic ClinicGroup PAC ID 7012963036, 2 clinicians

Practice addresses (Care Compare)

2025 Park St
Jacksonville, FL 32204-3809
Phone (904) 388-1811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH13110FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Five Points Medical Clinic Chiropractor PastSince Mar 31, 2020 Accepting new patients

Organizations & group practices 2

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1154959716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043809",
            "telephone_number": "904-388-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043809",
            "telephone_number": "904-388-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODD",
        "first_name": "RILEY",
        "middle_name": "SEAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-30",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.