Advanced Chiropractic Rehabilitation and Wellness Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH2831 Issued in FL

Legal business name

ADVANCED CHIROPRACTIC REHABILITATION AND WELLNESS CENTER

Practice address

15151 S US Highway 441
Summerfield, FL 34491-4481

Phone

(352) 307-0033

Fax

(352) 307-1998

NPI assigned

Nov 28, 2007

Last updated

Aug 5, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Frank Mammana, CHIROPRACTORNPI 1740206572

Title

Owner

Phone

(352) 307-0033

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Advanced Wellness & Chiropractic Clinic Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Frank Mammana, D.C.

  • Chiropractor
  • Summerfield, FL
  • NPI 1740206572
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249430400000",
    "number": "1255513602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15151 S US HIGHWAY 441",
            "address_2": "SUITE 200",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344914481",
            "telephone_number": "352-307-0033",
            "fax_number": "352-307-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15151 S US HIGHWAY 441",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344914481",
            "telephone_number": "352-307-0033",
            "fax_number": "352-307-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CHIROPRACTIC REHABILITATION AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2009-08-05",
        "status": "A",
        "authorized_official_last_name": "MAMMANA",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-307-0033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "CHIROPRACTOR"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NY",
            "license": "CH2831",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH2831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3813525-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Wellness & Chiropractic Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Chiropractor in Summerfield, FL
• Providers in Summerfield, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2009; 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.