Coastal Health and Wellness Jax LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

COASTAL HEALTH AND WELLNESS JAX LLC

Practice address

440 Third St.
Suite a
Neptune Beach Florida, FL 32266

Phone

(904) 249-5999

Fax

(904) 249-1768

NPI assigned

Nov 14, 2023

Last updated

Nov 14, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Susan Shepler, DCNPI 1033270566

Title

Owner/Chiropractor

Phone

(904) 249-5999

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan L. Shepler, D.C.

  • Chiropractor
  • Neptune Beach, FL
  • NPI 1033270566
  Medicare reassignment NPD Authorized official
• Thomas A. Kiska, D.C., D.A.C.B.N.

  • Chiropractor
  • Neptune Beach, FL
  • NPI 1215097787
  NPD

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699920000000",
    "number": "1215701826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 3RD ST STE A",
            "city": "NEPTUNE BEACH",
            "state": "FL",
            "postal_code": "322665146",
            "telephone_number": "904-249-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 THIRD ST.",
            "address_2": "SUITE A",
            "city": "NEPTUNE BEACH FLORIDA",
            "state": "FL",
            "postal_code": "32266",
            "telephone_number": "904-249-5999",
            "fax_number": "904-249-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL HEALTH AND WELLNESS JAX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-14",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A",
        "authorized_official_last_name": "SHEPLER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "904-249-5999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.