Jax Spine & Rehab PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH9780 Issued in FL

Legal business name

JAX SPINE & REHAB PLLC

Practice address

13475 Atlantic Blvd Ste 28
Jacksonville, FL 32225-3290

Phone

(904) 333-6164

NPI assigned

Oct 30, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Richard Adam Crosby, DC, ATCNPI 1407183965

Title

Ceo

Phone

(904) 333-6164

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.

• Richard Adam Crosby, D.C.

  • Chiropractor
  • Jacksonville, FL
  • NPI 1407183965
  Medicare reassignment NPD Authorized official
• Blake Moser, D.C.

  • Chiropractor
  • Jacksonville, FL
  • NPI 1467778761
  Medicare reassignment NPD

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1346594322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4216 RIPKEN CIR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322249675",
            "telephone_number": "904-333-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13475 ATLANTIC BLVD STE 28",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322253290",
            "telephone_number": "904-333-6164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAX SPINE & REHAB PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "CROSBY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-333-6164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, ATC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jax Nora One LLC
• Jax OB-GYN PA
• Jax Patient Care
• Jax Premier Health Center PLLC
• Jax Sleep Solutions LLC
• Jax Surgical Assist LLC
• Jax Vision Care, PA
• Jax Visiting Medical Providers LLC
• Jax'S Family Care and Research Center, P.a.
• Jax'S Family Care and Research Center, P.a.

• Chiropractor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.