Organization Active NPI

Conforti Chiropractic & Wellness Center Inc

  • Chiropractor
  • Oldsmar, FL
National Provider Identifier
1316010143
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7630 Issued in FL
Legal business name
CONFORTI CHIROPRACTIC & WELLNESS CENTER INC
Practice address
4040 Tampa Rd
Oldsmar, FL 34677-3205
Phone
(813) 818-7499
Fax
(813) 818-7239
NPI assigned
Nov 17, 2006
Last updated
Jan 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Authorized official

Name
George Wayne Blake
Title
Billing Manager
Phone
(813) 818-7499

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7630 FL Primary

Addresses

Primary practice location

4040 Tampa Rd
Oldsmar, FL 34677-3205

Mailing address

4040 Tampa Rd
Oldsmar, FL 34677-3205
Phone (813) 818-7499

Other identifiers 1

IdentifierTypeStateIssuer
002847800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041113000229 FL Part B Supplier - Clinic/Group Practice 8527022110 Receives reassigned benefits from 3 practitioners
Practice locations: Oldsmar, FL

National Provider Directory

National Provider Directory

Locations

4050 Tampa Rd
Ste D
Oldsmar, FL 34677
Phone (813) 818-7499

Practitioners & affiliated clinicians

Practitioners 9

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": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1316010143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 TAMPA RD",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346773205",
            "telephone_number": "813-818-7499",
            "fax_number": "813-818-7239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 TAMPA RD",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346773205",
            "telephone_number": "813-818-7499",
            "fax_number": "813-818-7239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONFORTI CHIROPRACTIC & WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "813-818-7499"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002847800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oldsmar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.