Jax Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

JAX CHIROPRACTIC PLLC

Practice address

12086 Fort Caroline Rd Ste 302
Jacksonville, FL 32225-7639

Phone

(904) 564-2500

NPI assigned

Mar 1, 2021

Organization subpart

No

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

Authorized official

Name

Blake Christian Moser, DC

Title

Ower/Chiropractor

Phone

(352) 874-3393

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1366037434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 MARSH COVE DR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320821837",
            "telephone_number": "352-874-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12086 FORT CAROLINE RD STE 302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322257639",
            "telephone_number": "904-564-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAX CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "MOSER",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "CHRISTIAN",
        "authorized_official_title_or_position": "OWER/CHIROPRACTOR",
        "authorized_official_telephone_number": "352-874-3393",
        "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": []
}

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• 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 Mar 1, 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.