Individual provider Active NPI

Foy Edward Dark Jr., DC

  • Chiropractor
  • Leesburg, FL
National Provider Identifier
1174628481
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH3542 Issued in FL
Practice address
32629 Blossom Lane
Leesburg, FL 34788
Phone
(352) 326-2481
Fax
(352) 326-2483
NPI assigned
Sep 13, 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
Chiropractor 111N00000X CH3542 FL Primary

Addresses

Primary practice location

32629 Blossom Lane
Leesburg, FL 34788

Mailing address

32629 Blossom Lane
Leesburg, FL 34788
Phone (352) 326-2481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH3542FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Restoration Spine and Sport, LLC Chiropractor PastSince Aug 1, 2020 Accepting new patients
Ronald B. Moussette DC, PA Chiropractor Past Accepting new patients
Lake Square Chiropractic, P.a. Chiropractor PastSince Jul 27, 2020 Accepting new patients

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174628481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32629 BLOSSOM LANE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "34788",
            "telephone_number": "352-326-2481",
            "fax_number": "352-326-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32629 BLOSSOM LANE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "34788",
            "telephone_number": "352-326-2481",
            "fax_number": "352-326-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARK",
        "first_name": "FOY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH3542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.