Individual provider Active NPI

Christhian Louis Vera-Morales, D.C

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1235784125
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12848 Issued in FL
Practice address
Edwards Chriopractic Offices P.a
4558 San Juan Ave.
Jacksonville, FL 32210-2051
Phone
(904) 389-0667
Fax
(904) 389-5871
NPI assigned
Aug 7, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12848 FL Primary

Addresses

Primary practice location

Edwards Chriopractic Offices P.a
4558 San Juan Ave.
Jacksonville, FL 32210-2051

Mailing address

Edwards Chriopractic Offices P.a
4558 San Juan Ave.
Jacksonville, FL 32210-2051
Phone (904) 389-0667

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191120001959 FL Practitioner - Chiropractic 6507298106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edwards Chiropratic Offices PAGroup PAC ID 5193781847, 3 clinicians

Practice addresses (Care Compare)

4558 San Juan Ave
Jacksonville, FL 32210-2051
Phone (904) 398-0667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH12848FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Edwards Chiropratic Offices PA Chiropractor CurrentSince Aug 14, 2019 Accepting new patients
Edwards Chiropractic PA Chiropractor PastSince Aug 14, 2019 Accepting new patients

Locations

4558 San Juan Ave
Jacksonville, FL 32210
Phone (904) 389-0667

4558 San Juan Ave
Ofc Pa
Jacksonville, FL 32210
Phone (904) 389-0667

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": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1235784125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EDWARDS CHRIOPRACTIC OFFICES P.A",
            "address_2": "4558 SAN JUAN AVE.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102051",
            "telephone_number": "904-389-0667",
            "fax_number": "904-389-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EDWARDS CHRIOPRACTIC OFFICES P.A",
            "address_2": "4558 SAN JUAN AVE.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102051",
            "telephone_number": "904-389-0667",
            "fax_number": "904-389-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERA-MORALES",
        "first_name": "CHRISTHIAN",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-07",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.