Beachtown Chiropractic Co., LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH12515 Issued in FL

Legal business name

BEACHTOWN CHIROPRACTIC CO., LLC

Practice address

15600 Panama City Beach Pkwy Unit 700
Panama City Beach, FL 32413-5430

Phone

(334) 790-0484

NPI assigned

Jul 11, 2018

Last updated

Oct 24, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey Tyler Gregory, DCNPI 1457837650

Title

Doctor of Chiropractic

Phone

(334) 790-0484

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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.

• Jeffrey Tyler Gregory, DC

  • Chiropractor
  • Panama City Beach, FL
  • NPI 1457837650
  Medicare reassignment NPD Authorized official
• Marcus Keith Woodburn

  • Chiropractor
  • Leland, NC
  • NPI 1548766827
  NPD (past)

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1336625532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 AIRPORT RD STE C",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368305701",
            "telephone_number": "334-212-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 PANAMA CITY BEACH PKWY UNIT 700",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324135430",
            "telephone_number": "334-790-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHTOWN CHIROPRACTIC CO., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-11",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "334-790-0484",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bay Pharma of Florida Inc (Bay rx pharmacy)
• Bay Point Healthcare LLC
• Beach Chiropractic Clinic LLC
• Beach Medical Express LLC
• Beachcomber Retreat, LLC (Bridging the Gap Recovery)
• Behavioral and Life Connections (B L C)
• Caroleen Nabeel Bejimi
• Amy Leigh Bell, D.C.
• Moriah Bell, M.S.
• Megan Aspasia Benopoulos

• Chiropractor in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• Chiropractor in Florida

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