Individual provider Active NPI

Ronald L Harrell, D.C.

  • Chiropractor
  • Lake Wales, FL
National Provider Identifier
1285640136
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH4000 Issued in FL
Practice address
343 W Central Ave
Suite 3
Lake Wales, FL 33853-4059
Phone
(863) 676-7619
Fax
(863) 676-7610
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH4000 FL Primary

Addresses

Primary practice location

343 W Central Ave
Suite 3
Lake Wales, FL 33853-4059

Mailing address

343 W Central Ave
Suite 3
Lake Wales, FL 33853-4059
Phone (863) 676-7619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH4000FLMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1285640136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 W CENTRAL AVE",
            "address_2": "SUITE 3",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534059",
            "telephone_number": "863-676-7619",
            "fax_number": "863-676-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 W CENTRAL AVE",
            "address_2": "SUITE 3",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534059",
            "telephone_number": "863-676-7619",
            "fax_number": "863-676-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "RONALD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH4000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.