Individual provider Active NPI

James Vincent Theriault, D.C.

  • Chiropractor
  • Venice, FL
National Provider Identifier
1235143488
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0003467 Issued in FL
Practice address
1846 Tamiami TRL S
Unit 101
Venice, FL 34293-3135
Phone
(941) 497-7005
Fax
(941) 493-6905
NPI assigned
Jul 27, 2006
Last updated
Jan 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0003467 FL Primary

Addresses

Primary practice location

1846 Tamiami TRL S
Unit 101
Venice, FL 34293-3135

Mailing address

1846 Tamiami TRL S
Unit 1
Venice, FL 34293-3135
Phone (941) 497-7005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100927001471 FL Practitioner - Chiropractic 5294851267 Practice locations: Venice, FL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1980
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1846 S Tamiami Trial
Unit 101
Venice, FL 34293
Phone (941) 497-7005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0003467FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Theriault Chiropractic Chiropractor CurrentSince Feb 19, 2023 Accepting new patients

Locations

1846 S Tamiami Trl
Ste 1
Venice, FL 34293
Phone (941) 497-7005

Organizations & group practices 1

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1235143488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1846 TAMIAMI TRL S",
            "address_2": "UNIT 1",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342933135",
            "telephone_number": "941-497-7005",
            "fax_number": "941-493-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1846 TAMIAMI TRL S",
            "address_2": "UNIT 101",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342933135",
            "telephone_number": "941-497-7005",
            "fax_number": "941-493-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERIAULT",
        "first_name": "JAMES",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0003467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; 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.