Bradley Havlicek, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH11280 Issued in FL

Practice address

2085 A1A S
Ste 103
Saint Augustine, FL 32080-6505

Phone

(904) 515-2225

NPI assigned

Sep 23, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Havlicek Chiropractic Inc

  • Chiropractor
  • St Augustine, FL
  • NPI 1720497340
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494979200000",
    "number": "1245632017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 A1A S",
            "address_2": "STE 103",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320806505",
            "telephone_number": "904-515-2225",
            "fax_number": "904-515-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 A1A S",
            "address_2": "STE 103",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320806505",
            "telephone_number": "904-515-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVLICEK",
        "first_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2017-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hassan Ali Hassan, M.D.
• Cyndie S. Hatcher
• Hathor Inc
• Emily Hattory, RBT
• Havlicek Chiropractic Inc
• Michael Joseph Havro, PA-C
• Haydon-Davis Counseling, Inc.
• Gabrielle Haye
• Emmeline Hayes, LMHC
• Leilani Melissa Hayes, L.M.T.; L.P.N.

• Chiropractor in Saint Augustine, FL
• Providers in Saint Augustine, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2017; 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.