NPIMap

Organization Active NPI

Mallory Chiropractic Clinic PA

Doing business as Neck Back & Headache Relief Center

  • Chiropractor
  • Daytona Beach, FL
National Provider Identifier
1164408696
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0005944 Issued in FL
Legal business name
MALLORY CHIROPRACTIC CLINIC PA
Doing business as
Neck Back & Headache Relief Center
Practice address
1033 S Ridgewood Ave
Daytona Beach, FL 32114-6151
Phone
(386) 248-8000
Fax
(386) 252-1850
NPI assigned
Dec 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Authorized official

Name
Dr. David A Mallory, DC
Title
Owner
Phone
(386) 248-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH0005944 FL Primary

Addresses

Primary practice location

1033 S Ridgewood Ave
Daytona Beach, FL 32114-6151

Mailing address

1033 S Ridgewood Ave
Daytona Beach, FL 32114-6151
Phone (386) 248-8000

Other identifiers 2

IdentifierTypeStateIssuer
380856400MedicaidFL
350049800OtherFLRAILROAD MEDICARE

Other names 1

  • NECK BACK & HEADACHE RELIEF CENTER Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1164408696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 S RIDGEWOOD AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321146151",
            "telephone_number": "386-248-8000",
            "fax_number": "386-252-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 S RIDGEWOOD AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321146151",
            "telephone_number": "386-248-8000",
            "fax_number": "386-252-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLORY CHIROPRACTIC CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "MALLORY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-248-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0005944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380856400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350049800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NECK BACK & HEADACHE RELIEF CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; 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.