NPIMap

Organization Active NPI

Changing Tides Chiropractic & Wellness, LLC.

  • Chiropractor
  • Saint Augustine, FL
National Provider Identifier
1194290320
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHANGING TIDES CHIROPRACTIC & WELLNESS, LLC.
Practice address
1000 Plantation Island Dr S Ste 9
Saint Augustine, FL 32080-3106
Phone
(904) 217-0715
NPI assigned
Oct 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Authorized official

Name
Eliana Maria Melendez-Santiago, D.C.
Title
Owner
Phone
(904) 217-0715

Specialties & licenses 1

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

Addresses

Primary practice location

1000 Plantation Island Dr S Ste 9
Saint Augustine, FL 32080-3106

Mailing address

1000 Plantation Island Dr S Ste 9
Saint Augustine, FL 32080-3106
Phone (904) 217-0715

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1194290320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 PLANTATION ISLAND DR S STE 9",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320803106",
            "telephone_number": "904-217-0715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PLANTATION ISLAND DR S STE 9",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320803106",
            "telephone_number": "904-217-0715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING TIDES CHIROPRACTIC & WELLNESS, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "MELENDEZ-SANTIAGO",
        "authorized_official_first_name": "ELIANA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-217-0715",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.