Individual provider Active NPI

Andrea Lynne Lagnese, D.C.

  • Chiropractor
  • Ponte Vedra Beach, FL
National Provider Identifier
1245259951
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8112 Issued in FL
Practice address
135 Professional Dr Ste 105
Ponte Vedra Beach, FL 32082-7228
Phone
(904) 280-1101
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR006490 GA
Chiropractor 111N00000X CH8112 FL Primary

Addresses

Primary practice location

135 Professional Dr Ste 105
Ponte Vedra Beach, FL 32082-7228

Mailing address

14156 Hampton Falls Dr N
Jacksonville, FL 32224-3859
Phone (904) 699-5432

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191108001079 FL Practitioner - Chiropractic 4587603196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr. Kelly J. Huber, IncGroup PAC ID 6103086780, 2 clinicians

Practice addresses (Care Compare)

11512 Lake Mead Ave
Unit 203
Jacksonville, FL 32256-9688
Phone (904) 565-1116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR006490GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Kelly J. Huber, Inc Chiropractor CurrentSince Apr 28, 2023 Accepting new patients

Locations

11512 Lake Mead Ave
Unit 203
Jacksonville, FL 32256
Phone (904) 565-1116

135 Professional Dr
Ponte Vedra Beach, FL 32082
Phone (904) 280-1101

135 Professional Dr
Ste 105
Ponte Vedra Beach, FL 32082
Phone (904) 280-1101

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1245259951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14156 HAMPTON FALLS DR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322243859",
            "telephone_number": "904-699-5432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PROFESSIONAL DR STE 105",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320827228",
            "telephone_number": "904-280-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGNESE",
        "first_name": "ANDREA",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR006490",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.