Individual provider Active NPI

Robert Trevor Hardman

  • Chiropractor
  • St Johns, FL
National Provider Identifier
1174085559
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12770 Issued in FL
Practice address
155 Fountains Way Ste 6
St Johns, FL 32259-1144
Phone
(904) 342-5455
NPI assigned
Apr 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12770 FL Primary

Addresses

Primary practice location

155 Fountains Way Ste 6
St Johns, FL 32259-1144

Mailing address

4959 NW 115TH Way
Coral Springs, FL 33076-3208

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190415001376 FL Practitioner - Chiropractic 3577804848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Center LLCGroup PAC ID 2466849682, 2 clinicians

Practice addresses (Care Compare)

155 Fountains Way
Suite 6
St Johns, FL 32259-1144
Phone (904) 342-5455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Center LLC Chiropractor CurrentSince Dec 15, 2021 Accepting new patients

Locations

155 Fountains Way
Ste 6
St Johns, FL 32259
Phone (904) 342-5455

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": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1174085559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4959 NW 115TH WAY",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 FOUNTAINS WAY STE 6",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322591144",
            "telephone_number": "904-342-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDMAN",
        "first_name": "ROBERT",
        "middle_name": "TREVOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johns, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.