Chase Daniel Vanderpol, D.C.
Individual provider Active NPI Chiropractor · St Johns, FL
NPI 1255978441 · NPPES record last updated May 19, 2022
Key facts
- NPI
- 1255978441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CH13291 (FL)
- Practice address
- 155 Bartram Market Dr Ste 113
St Johns, FL 32259-4582 - Phone
- (970) 456-7676
- NPI assigned
- Dec 6, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St. John'S Chiropractic, LLC
Practice addresses (Care Compare)
155 Bartram Market Dr
Suite 113
St Johns, FL 32259-4582
Phone (904) 290-1312
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210224002473 | FL | Practitioner - Chiropractic | 9931534716 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH13291 | FL | MD | Chiropractor |
| 4511 | SC | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Johns Chiropractic, PLLC | Chiropractor | Current |
Accepting new patients |
Locations
155 Bartram Market Dr
Ste 113
St Johns, FL 32259
Phone (904) 290-1312
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH13291 | FL | Yes |
Addresses
Primary practice location
155 Bartram Market Dr Ste 113
St Johns, FL 32259-4582
Mailing address
155 Bartram Market Dr Ste 113
St Johns, FL 32259-4582
Phone (970) 456-7676
Other providers in St Johns, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.