Organization Active NPI

Land Chiropractic and Sports Clinic LLC

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1164688354
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9603 Issued in FL
Legal business name
LAND CHIROPRACTIC AND SPORTS CLINIC LLC
Practice address
8823 San Jose Blvd
Suite 201
Jacksonville, FL 32217-4287
Phone
(904) 338-9995
NPI assigned
Aug 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2008

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

Authorized official

Name
Dr. Christopher Michael Land, D.C.NPI 1376706143
Title
Owner
Phone
(904) 477-5057

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH9603 FL Primary

Addresses

Primary practice location

8823 San Jose Blvd
Suite 201
Jacksonville, FL 32217-4287

Mailing address

8823 San Jose Blvd
Suite 201
Jacksonville, FL 32217-4287
Phone (904) 338-9995

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090122000717 FL Part B Supplier - Clinic/Group Practice 4183788912 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

8823 San Jose Blvd
Ste 201
Jacksonville, FL 32217
Phone (904) 338-9995

Practitioners & affiliated clinicians

Practitioners 1

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": "1217980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1164688354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 SAN JOSE BLVD",
            "address_2": "SUITE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174287",
            "telephone_number": "904-338-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8823 SAN JOSE BLVD",
            "address_2": "SUITE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174287",
            "telephone_number": "904-338-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAND CHIROPRACTIC AND SPORTS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-06",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "LAND",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-477-5057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9603",
            "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 Sep 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.