Individual provider Active NPI

Alexandra Crespo Davila, DC

  • Chiropractor
  • Port Orange, FL
National Provider Identifier
1194293100
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12634 Issued in FL
Practice address
1125 Harbour Point Dr
Port Orange, FL 32127-5605
Phone
(787) 904-2160
NPI assigned
Nov 7, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12634 FL Primary

Addresses

Primary practice location

1125 Harbour Point Dr
Port Orange, FL 32127-5605

Mailing address

1125 Harbour Point Dr
Port Orange, FL 32127-5605
Phone (787) 904-2160

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240529004115 FL Practitioner - Chiropractic 7315388089 Reassigns benefits to 1 organization
Practice locations: Sebastian, FL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clark Chiropractic and Wellness PLLCGroup PAC ID 1254772924, 2 clinicians

Practice addresses (Care Compare)

709 Sebastian Blvd
Suite F
Sebastian, FL 32958-8704
Phone (772) 202-7236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH12634FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Next Medical Florida LLC Chiropractor CurrentSince Aug 16, 2024 Accepting new patients
Clark Chiropractic and Wellness PLLC Chiropractor CurrentSince Jan 21, 2024 Accepting new patients

Locations

877 S Orange Blossom Trl
Forest City, FL 32703
Phone (407) 889-3223

6285 Minton Rd NE
Palm Bay, FL 32907
Phone (321) 306-0300

709 Sebastian Blvd
Ste F
Sebastian, FL 32958
Phone (772) 202-7236

Organizations & group practices 2

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": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1194293100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 HARBOUR POINT DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321275605",
            "telephone_number": "787-904-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 HARBOUR POINT DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321275605",
            "telephone_number": "787-904-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRESPO DAVILA",
        "first_name": "ALEXANDRA",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12634",
            "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 Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.