Organization Active NPI

Jachimek Chiropractic Clinic, P.a.

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1316128739
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6622 Issued in FL
Legal business name
JACHIMEK CHIROPRACTIC CLINIC, P.A.
Practice address
5111 Ehrlich Rd
Suite 128
Tampa, FL 33624-2075
Phone
(813) 960-2225
Fax
(813) 968-1784
NPI assigned
Nov 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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

Authorized official

Name
Dr. Richard Henry Jachimek, D.C.NPI 1811061047
Title
President
Phone
(813) 960-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH6622 FL Primary

Addresses

Primary practice location

5111 Ehrlich Rd
Suite 128
Tampa, FL 33624-2075

Mailing address

5111 Ehrlich Rd
Suite 128
Tampa, FL 33624-2075
Phone (813) 960-2225

Other identifiers 1

IdentifierTypeStateIssuer
382258300MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060420000529 FL Part B Supplier - Clinic/Group Practice 3870502735 Receives reassigned benefits from 1 practitioner
Practice locations: Springhill, FL; Tampa, FL

National Provider Directory

National Provider Directory

Locations

1910 W Busch Blvd
Tampa, FL 33612
Phone (813) 960-2225

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1316128739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 EHRLICH RD",
            "address_2": "SUITE 128",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242075",
            "telephone_number": "813-960-2225",
            "fax_number": "813-968-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 EHRLICH RD",
            "address_2": "SUITE 128",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242075",
            "telephone_number": "813-960-2225",
            "fax_number": "813-968-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACHIMEK CHIROPRACTIC CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "JACHIMEK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-960-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382258300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; 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.