Progressive Medical Group PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

CH6815 Issued in FL

Legal business name

PROGRESSIVE MEDICAL GROUP PA

Doing business as

West Bay Chiropractic

Practice address

8730 Fountain Ave
Tampa, FL 33615-2802

Phone

(813) 885-6001

Fax

(813) 885-6874

NPI assigned

Oct 16, 2006

Last updated

Apr 1, 2013By 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. William Lichter, DCNPI 1396704250

Title

President

Phone

(813) 885-6001

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• West Bay Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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.

• William I Lichter, D.C.

  • Chiropractor
  • Tampa, FL
  • NPI 1396704250
  Medicare reassignment Authorized official
• Cameron M Banks, D.C.

  • Orthopedic Chiropractor
  • Snellville, GA
  • NPI 1255748968

  FL

  Medicare reassignment NPD
• Shay David Ridge, D.C.

  • Chiropractor
  • Largo, FL
  • NPI 1912270018
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364774400000",
    "number": "1285714394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8730 FOUNTAIN AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336152802",
            "telephone_number": "813-885-6001",
            "fax_number": "813-885-6874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8730 FOUNTAIN AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336152802",
            "telephone_number": "813-885-6001",
            "fax_number": "813-885-6874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2013-04-01",
        "status": "A",
        "authorized_official_last_name": "LICHTER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-885-6001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "CH6815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380716900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Bay Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mario E Profet, MD, RDMS, RDCS, RPVI
• Daniele Profilo, M.S.
• Proformance Sports LLC
• Progress and Change Therapy LLC
• Progressive Family Care LLC
• Progressus Therapy
• Progressus Therapy, LLC
• Progressus Therapy, LLC
• Project Return, Inc.
• Victoria Prokic, CRNA

• Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.