Individual provider Active NPI

Jolene D Patterson, DC

  • Chiropractor
  • Saint Cloud, FL
National Provider Identifier
1194234336
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010593 Issued in MI
Practice address
4273 Neptune Rd
Saint Cloud, FL 34769-6744
Phone
(248) 701-5781
NPI assigned
Sep 20, 2017
Last updated
Aug 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010593 MI Primary

Addresses

Primary practice location

4273 Neptune Rd
Saint Cloud, FL 34769-6744

Mailing address

109 Lake Davenport Blvd
Davenport, FL 33897-9405
Phone (863) 256-5030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190213000570 FL Practitioner - Chiropractic 8729352836 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Neptune Chiropractic and Wellness CurrentSince Aug 12, 2022 Accepting new patients
Neptune Medical Group Chiropractor Current Accepting new patients
Four Corners Chiropractic Centers PA Chiropractor PastSince Feb 11, 2019 Accepting new patients
Michigan Chiropractic Specialists of Waterford, P.C. Chiropractor PastSince Feb 27, 2018 Accepting new patients

Locations

4273 Neptune Rd
Saint Cloud, FL 34769
Phone (248) 701-5781

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1194234336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 LAKE DAVENPORT BLVD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338979405",
            "telephone_number": "863-256-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4273 NEPTUNE RD",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696744",
            "telephone_number": "248-701-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "JOLENE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.