Organization Active NPI

Shafer Chiropractic Clinic Inc

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1255450599
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0005031 Issued in FL
Legal business name
SHAFER CHIROPRACTIC CLINIC INC
Practice address
2253 Park St
Jacksonville, FL 32204-4315
Phone
(904) 387-1795
Fax
(904) 387-1763
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Authorized official

Name
Dr. Erich Ernest Shafer, D.C.
Title
President
Phone
(904) 387-1795

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH0005031 FL Primary

Addresses

Primary practice location

2253 Park St
Jacksonville, FL 32204-4315

Mailing address

2253 Park St
Jacksonville, FL 32204-4315
Phone (904) 387-1795

National Provider Directory

National Provider Directory

Locations

2253 Park St
Jacksonville, FL 32204
Phone (904) 387-1795

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184112000000",
    "number": "1255450599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2253 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044315",
            "telephone_number": "904-387-1795",
            "fax_number": "904-387-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044315",
            "telephone_number": "904-387-1795",
            "fax_number": "904-387-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAFER CHIROPRACTIC CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-11",
        "status": "A",
        "authorized_official_last_name": "SHAFER",
        "authorized_official_first_name": "ERICH",
        "authorized_official_middle_name": "ERNEST",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-387-1795",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0005031",
            "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 Jul 11, 2007; 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.