Organization Active NPI

Mobile Chiro and Performance, LLC

  • Chiropractor
  • New Smyrna Beach, FL
National Provider Identifier
1356989131
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MOBILE CHIRO AND PERFORMANCE, LLC
Practice address
604 Edward St
New Smyrna Beach, FL 32168-6649
Phone
(386) 259-8365
NPI assigned
Dec 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Authorized official

Name
Dr. Kory Adam Pugh, DCNPI 1144672684
Title
Chiropractic Physician
Phone
(386) 259-8365

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

604 Edward St
New Smyrna Beach, FL 32168-6649

Mailing address

604 Edward St
New Smyrna Beach, FL 32168-6649
Phone (386) 259-8365

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1356989131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 EDWARD ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686649",
            "telephone_number": "386-259-8365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 EDWARD ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686649",
            "telephone_number": "386-259-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE CHIRO AND PERFORMANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-12",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "PUGH",
        "authorized_official_first_name": "KORY",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "386-259-8365",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.