Individual provider Active NPI

Gilbert A Machaceck, DC DABCO

  • Chiropractor
  • St Petersburg, FL
National Provider Identifier
1316934987
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0004024 Issued in FL
Practice address
2201 58TH Street N
St Petersburg, FL 33710
Phone
(727) 347-7827
Fax
(727) 548-5540
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0004024 FL Primary

Addresses

Primary practice location

2201 58TH Street N
St Petersburg, FL 33710

Mailing address

2201 58TH Street N
St Petersburg, FL 33710
Phone (727) 347-7827

Other identifiers 2

IdentifierTypeStateIssuer
380788600MedicaidFL
22410OtherFLBCBS

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
CH0004024FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Donald J. Krippendorf PA Chiropractor Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1316934987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 58TH STREET N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33710",
            "telephone_number": "727-347-7827",
            "fax_number": "727-548-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 58TH STREET N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33710",
            "telephone_number": "727-347-7827",
            "fax_number": "727-548-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHACECK",
        "first_name": "GILBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC DABCO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0004024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380788600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "22410",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.