Individual provider Active NPI

John Jack Fakhouri, DC

  • Chiropractor
  • Lake Worth, FL
National Provider Identifier
1346029279
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH14604 Issued in FL
Practice address
7012 Charleston Shores Blvd
Lake Worth, FL 33467-7628
Phone
(561) 969-8284
NPI assigned
Sep 28, 2023
Last updated
Jul 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH14604 FL Primary

Addresses

Primary practice location

7012 Charleston Shores Blvd
Lake Worth, FL 33467-7628

Mailing address

7012 Charleston Shores Blvd
Lake Worth, FL 33467-7628
Phone (561) 420-9791

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250627000647 FL Practitioner - Chiropractic 3173036845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7012 Charleston Shores Blvd
Lake Worth, FL 33467-7628
Phone (561) 969-8284

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH14604FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Vibrant Vertebrae Chiropractor CurrentSince Jun 1, 2025 Accepting new patients

Locations

500 NE Spanish River Blvd
Ste 35
Boca Raton, FL 33431
Phone (561) 338-5111

7012 Charleston Shores Blvd
Lake Worth, FL 33467
Phone (561) 969-8284

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1346029279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7012 CHARLESTON SHORES BLVD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334677628",
            "telephone_number": "561-420-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7012 CHARLESTON SHORES BLVD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334677628",
            "telephone_number": "561-969-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHOURI",
        "first_name": "JOHN",
        "middle_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-28",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.