NPIMap

Organization Active NPI

Edwards Chiropractic PA

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1245221399
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
EDWARDS CHIROPRACTIC PA
Practice address
4558 San Juan Ave
Jacksonville, FL 32210-2051
Phone
(904) 389-0667
Fax
(904) 389-5871
NPI assigned
Oct 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Harry D Edwards, DC
Title
President of PA
Phone
(904) 389-0667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

4558 San Juan Ave
Jacksonville, FL 32210-2051

Mailing address

4558 San Juan Ave
Jacksonville, FL 32210-2051
Phone (904) 389-0667

National Provider Directory

National Provider Directory
Tax ID family
Edwards Chiropractic PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245221399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "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": "4558 SAN JUAN AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102051",
            "telephone_number": "904-389-0667",
            "fax_number": "904-389-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARDS CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT OF PA",
        "authorized_official_telephone_number": "904-389-0667",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "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 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.