Organization Active NPI

Monahan Chiropractic PA

  • Rehabilitation Chiropractor
  • Jacksonville, FL
National Provider Identifier
1265703367
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
CH3212 Issued in FL
Legal business name
MONAHAN CHIROPRACTIC PA
Practice address
4022 Blanding Blvd
Jacksonville, FL 32210-5417
Phone
(904) 778-7963
Fax
(904) 779-1329
NPI assigned
Jan 20, 2012
Last updated
Jan 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Authorized official

Name
Dr. Stephen M Monahan, D.C.
Title
Owner
Phone
(904) 923-0968

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X CH3212 FL Primary

Addresses

Primary practice location

4022 Blanding Blvd
Jacksonville, FL 32210-5417

Mailing address

4022 Blanding Blvd
Jacksonville, FL 32210-5417
Phone (904) 778-7963

Other identifiers 1

IdentifierTypeStateIssuer
88420OtherFLMEDICARE PROVIDER NUMBER

National Provider Directory

National Provider Directory

Locations

4022 Blanding Blvd
Jacksonville, FL 32210
Phone (904) 778-7963

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327017600000",
    "number": "1265703367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4022 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322105417",
            "telephone_number": "904-778-7963",
            "fax_number": "904-779-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4022 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322105417",
            "telephone_number": "904-778-7963",
            "fax_number": "904-779-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONAHAN CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-20",
        "last_updated": "2012-01-20",
        "status": "A",
        "authorized_official_last_name": "MONAHAN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-923-0968",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "FL",
            "license": "CH3212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "88420",
            "state": "FL"
        }
    ],
    "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 Jan 20, 2012; 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.