Organization Active NPI

Signature Chiropractic

  • Chiropractor
  • Riverview, FL
National Provider Identifier
1245635101
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH11258 Issued in FL
Legal business name
SIGNATURE CHIROPRACTIC
Practice address
9420 Balm Riverview Rd
Riverview, FL 33569-5116
Phone
(813) 672-1818
Fax
(813) 642-7145
NPI assigned
Nov 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Authorized official

Name
Dr. Tiffany Le, DCNPI 1437554391
Title
President
Phone
(813) 672-1818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH11258 FL Primary

Addresses

Primary practice location

9420 Balm Riverview Rd
Riverview, FL 33569-5116

Mailing address

9420 Balm Riverview Rd
Riverview, FL 33569-5116
Phone (813) 672-1818

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150112000557 FL Part B Supplier - Clinic/Group Practice 2062736515 Receives reassigned benefits from 1 practitioner
Practice locations: Riverview, FL

National Provider Directory

National Provider Directory

Locations

9420 Balm Riverview Rd
Riverview, FL 33569
Phone (813) 672-1818

11952 Boyette Rd
Riverview, FL 33569
Phone (813) 321-7411

Practitioners & affiliated clinicians

Practitioners 1

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": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558051200000",
    "number": "1245635101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9420 BALM RIVERVIEW RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695116",
            "telephone_number": "813-672-1818",
            "fax_number": "813-642-7145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9420 BALM RIVERVIEW RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695116",
            "telephone_number": "813-672-1818",
            "fax_number": "813-642-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-04",
        "last_updated": "2019-05-17",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-672-1818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.