Individual provider Active NPI

Austin Michael Mead, D.C.

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1336541077
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11322 Issued in FL
Practice address
13453 N Main St Ste 501
Jacksonville, FL 32218-2774
Phone
(904) 783-0008
Fax
(904) 783-0508
NPI assigned
Sep 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 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 11322 FL Primary

Addresses

Primary practice location

13453 N Main St Ste 501
Jacksonville, FL 32218-2774

Mailing address

13453 N Main St Ste 501
Jacksonville, FL 32218-2774
Phone (904) 783-0008

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150416000501 FL Practitioner - Chiropractic 7810215142 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11322FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mediquick Urgent Care Centers Inc CurrentSince Aug 27, 2023 Accepting new patients
Rta Health Care Chiropractor Past Accepting new patients

Locations

91 Branscomb Rd
Ste 1
Green Cove Springs, FL 32043
Phone (904) 783-0008

Organizations & group practices 3

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": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1336541077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13453 N MAIN ST STE 501",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322182774",
            "telephone_number": "904-783-0008",
            "fax_number": "904-783-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13453 N MAIN ST STE 501",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322182774",
            "telephone_number": "904-783-0008",
            "fax_number": "904-783-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEAD",
        "first_name": "AUSTIN",
        "middle_name": "MICHAEL",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-25",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "11322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.