Individual provider Active NPI

Adam Richard Spanovich, D.C

  • Chiropractor
  • Melbourne, FL
National Provider Identifier
1245683028
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11902 Issued in FL
Practice address
2351 W Eau Gallie Blvd
Melbourne, FL 32935-3114
Phone
(321) 622-6610
Fax
(321) 622-6716
NPI assigned
Jul 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11902 FL Primary

Addresses

Primary practice location

2351 W Eau Gallie Blvd
Melbourne, FL 32935-3114

Mailing address

7345 Grissom Pkwy
Cocoa, FL 32927-3260
Phone (740) 391-5063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11902FLMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
3 Rivers Injury Center Chiropractor PastSince Oct 10, 2021 Accepting new patients

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": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1245683028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7345 GRISSOM PKWY",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329273260",
            "telephone_number": "740-391-5063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 W EAU GALLIE BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353114",
            "telephone_number": "321-622-6610",
            "fax_number": "321-622-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANOVICH",
        "first_name": "ADAM",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-18",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "11902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; 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.