Individual provider Active NPI

Thomas A. Kiska, D.C., D.A.C.B.N.

  • Chiropractor
  • Neptune Beach, FL
National Provider Identifier
1215097787
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0006291 Issued in FL
Practice address
440 3Rd St
Suite a
Neptune Beach, FL 32266-5111
Phone
(904) 249-5999
Fax
(904) 249-1768
NPI assigned
Dec 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0006291 FL Primary

Addresses

Primary practice location

440 3Rd St
Suite a
Neptune Beach, FL 32266-5111

Mailing address

440 3Rd St
Suite a
Neptune Beach, FL 32266-5111
Phone (904) 249-5999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121000933 FL Practitioner - Chiropractic 8325227382

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0006291FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Health and Wellness Jax LLC Chiropractor CurrentSince Nov 19, 2023 Accepting new patients

Locations

440 3rd St
Ste A
Neptune Beach, FL 32266
Phone (904) 249-5999

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, 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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215097787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 3RD ST",
            "address_2": "SUITE A",
            "city": "NEPTUNE BEACH",
            "state": "FL",
            "postal_code": "322665111",
            "telephone_number": "904-249-5999",
            "fax_number": "904-249-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 3RD ST",
            "address_2": "SUITE A",
            "city": "NEPTUNE BEACH",
            "state": "FL",
            "postal_code": "322665111",
            "telephone_number": "904-249-5999",
            "fax_number": "904-249-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISKA",
        "first_name": "THOMAS",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.C., D.A.C.B.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0006291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.