Individual provider Active NPI

Elliot David Sherman, D.C.

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1356387013
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12945 Issued in FL
Practice address
1502 S Macdill Ave
Tampa, FL 33629-5214
Phone
(813) 563-0683
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12945 FL Primary

Addresses

Primary practice location

1502 S Macdill Ave
Tampa, FL 33629-5214

Mailing address

624 Oleander Way S
South Pasadena, FL 33707-2116
Phone (757) 831-9128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
CH12945FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
St. Pete Chiropractic and Injury Center LLC Chiropractor CurrentSince May 25, 2013 Accepting new patients

Locations

2206 4th St N
St Petersburg, FL 33704
Phone (727) 822-6700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1356387013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 OLEANDER WAY S",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337072116",
            "telephone_number": "757-831-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 S MACDILL AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295214",
            "telephone_number": "813-563-0683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "ELLIOT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.