Individual provider Active NPI

Jeffrey Neil Shebovsky, DC

  • Rehabilitation Chiropractor
  • Orlando, FL
National Provider Identifier
1164583654
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
CH6499 Issued in FL
Practice address
11364 S Orange Blossom TRL
Orlando, FL 32837-9426
Phone
(407) 857-6166
Fax
(407) 857-0122
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X CH6499 FL Primary

Addresses

Primary practice location

11364 S Orange Blossom TRL
Orlando, FL 32837-9426

Mailing address

11364 S Orange Blossom TRL
Orlando, FL 32837-9426
Phone (407) 857-6166

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090508000448 FL Practitioner - Chiropractic 0749242378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1991
Medicare assignment
May accept Medicare assignment
Group practices
Socc PLGroup PAC ID 4486702065, 4 clinicians

Practice addresses (Care Compare)

4170 Town Ctr Blvd
Suite 100
Orlando, FL 32837-5875
Phone (407) 857-6166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH6499FLMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Socc PL Rehabilitation CurrentSince Jan 1, 1990 Accepting new patients
Ownorth, PLLC CurrentSince Mar 22, 2016 Accepting new patients
Spine2 LLC PastSince Apr 30, 2003 Accepting new patients

Locations

2185 E Semoran Blvd
Apopka, FL 32703
Phone (407) 584-7100

4170 W Town Center Blvd
Ste 100
Orlando, FL 32837
Phone (407) 857-6166

Organizations & group practices 3

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164583654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11364 S ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328379426",
            "telephone_number": "407-857-6166",
            "fax_number": "407-857-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11364 S ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328379426",
            "telephone_number": "407-857-6166",
            "fax_number": "407-857-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEBOVSKY",
        "first_name": "JEFFREY",
        "middle_name": "NEIL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "FL",
            "license": "CH6499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.