Organization Active NPI

Focus Forward Chiropractic

  • Chiropractor
  • Port Orange, FL
National Provider Identifier
1326557604
Registry record updated May 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FOCUS FORWARD CHIROPRACTIC
Practice address
900 N Swallow Tail Dr
Port Orange, FL 32129
Phone
(518) 536-0574
NPI assigned
Sep 29, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2018

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

Authorized official

Name
Bethany RaudenbushNPI 1174032437
Title
Ceo
Phone
(386) 872-5313

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

900 N Swallow Tail Dr
Port Orange, FL 32129

Mailing address

1010 N Swallow Tail Dr Apt 803
Port Orange, FL 32129-4155
Phone (518) 536-0574

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180725000464 FL Part B Supplier - Clinic/Group Practice 8921355785 Receives reassigned benefits from 1 practitioner
Practice locations: Port Orange, FL

National Provider Directory

National Provider Directory

Locations

900 N Swallow Tail Dr
Ste 104D
Port Orange, FL 32129
Phone (386) 256-4805

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526860800000",
    "number": "1326557604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N SWALLOW TAIL DR APT 803",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294155",
            "telephone_number": "518-536-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N SWALLOW TAIL DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "32129",
            "telephone_number": "518-536-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOCUS FORWARD CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-29",
        "last_updated": "2018-05-21",
        "status": "A",
        "authorized_official_last_name": "RAUDENBUSH",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "386-872-5313"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; 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.