NPIMap

Organization Active NPI

Chiropractic Spine and Injury Center LLC

  • Chiropractor
  • Orange Park, FL
National Provider Identifier
1184903064
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIROPRACTIC SPINE AND INJURY CENTER LLC
Practice address
784 Blanding Blvd Ste 106
Orange Park, FL 32065-7724
Phone
(904) 276-7002
Fax
(904) 272-0086
NPI assigned
Aug 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Authorized official

Name
Dr. James W. Dautel, D.C.
Title
President/Cfo
Phone
(904) 276-7002

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X Primary
Nutrition ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NN1001X

Addresses

Primary practice location

784 Blanding Blvd Ste 106
Orange Park, FL 32065-7724

Mailing address

784 Blanding Blvd Ste 106
Orange Park, FL 32065-7724
Phone (904) 276-7002

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320019200000",
    "number": "1184903064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 BLANDING BLVD STE 106",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657724",
            "telephone_number": "904-276-7002",
            "fax_number": "904-272-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 BLANDING BLVD STE 106",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657724",
            "telephone_number": "904-276-7002",
            "fax_number": "904-272-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC SPINE AND INJURY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-10",
        "last_updated": "2011-10-31",
        "status": "A",
        "authorized_official_last_name": "DAUTEL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT/CFO",
        "authorized_official_telephone_number": "904-276-7002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.