Individual provider Active NPI

Jillian M Duquette, D.C.

  • Chiropractor
  • Port Orange, FL
National Provider Identifier
1194024729
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 10262 Issued in FL
Practice address
60 Golf Villa Dr
Port Orange, FL 32128-7265
Phone
(954) 579-0775
NPI assigned
Mar 22, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6595 CO
Chiropractor 111N00000X CH 10262 FL Primary

Addresses

Primary practice location

60 Golf Villa Dr
Port Orange, FL 32128-7265

Mailing address

60 Golf Villa Dr
Port Orange, FL 32128
Phone (954) 579-0775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220823001413 FL Practitioner - Chiropractic 4385027457 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6595COMDChiropractor
CH 10262FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Marcia C. Sasso, D.C., P.a. Chiropractor CurrentSince Aug 1, 2022 Accepting new patients

Locations

5663 NW 29th St
Margate, FL 33063
Phone (954) 974-3456

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": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1194024729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 GOLF VILLA DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "32128",
            "telephone_number": "954-579-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 GOLF VILLA DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321287265",
            "telephone_number": "954-579-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUQUETTE",
        "first_name": "JILLIAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "6595",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 10262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.