NPIMap

Organization Active NPI

Jacksonville Chiropractic & Rehabilitation

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1275914616
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
JACKSONVILLE CHIROPRACTIC & REHABILITATION
Practice address
2467 Faye Rd Ste 4
Jacksonville, FL 32226-2098
Phone
(904) 518-4555
Fax
(904) 518-4565
NPI assigned
Jun 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Authorized official

Name
Dr. Jeremiah Carlson, DC
Title
Director
Phone
(904) 518-4555

Specialties & licenses 1

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

Addresses

Primary practice location

2467 Faye Rd Ste 4
Jacksonville, FL 32226-2098

Mailing address

2467 Faye Rd Ste 4
Jacksonville, FL 32226-2098
Phone (904) 518-4555

National Provider Directory

National Provider Directory

Locations

2467 Faye Rd
Ste 4
Jacksonville, FL 32226
Phone (904) 518-4555

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1275914616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2467 FAYE RD STE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322262098",
            "telephone_number": "904-518-4555",
            "fax_number": "904-518-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2467 FAYE RD STE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322262098",
            "telephone_number": "904-518-4555",
            "fax_number": "904-518-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE CHIROPRACTIC & REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-518-4555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "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 Jun 11, 2015; 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.