Individual provider Active NPI

Christian B. Carlstrom, D.C.

  • Chiropractor
  • Jupiter, FL
National Provider Identifier
1366451288
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7662 Issued in FL
Practice address
1102 W Indiantown Rd
Suite 11
Jupiter, FL 33458-6813
Phone
(561) 741-1316
Fax
(561) 741-1375
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7662 FL Primary

Addresses

Primary practice location

1102 W Indiantown Rd
Suite 11
Jupiter, FL 33458-6813

Mailing address

1102 W Indiantown Rd
Suite 11
Jupiter, FL 33458-6813
Phone (561) 741-1316

Other identifiers 2

IdentifierTypeStateIssuer
381212000MedicaidFL
CH7662OtherFLSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090114000608 FL Practitioner - Chiropractic 4183787369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carlstrom Family Chiropractic Center PAGroup PAC ID 9830251248, 3 clinicians

Practice addresses (Care Compare)

1102 W Indiantown Rd
Suite 11
Jupiter, FL 33458-6813
Phone (561) 741-1316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carlstrom Family Chiropractic Center PA Chiropractor CurrentSince Sep 1, 2008 Accepting new patients
Nielson Family Chiropractic PLLC Chiropractor PastSince Sep 1, 2022 Accepting new patients

Locations

1102 W Indiantown Rd
Ste 11
Jupiter, FL 33458
Phone (561) 741-1316

Organizations & group practices 2

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1366451288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 W INDIANTOWN RD",
            "address_2": "SUITE 11",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334586813",
            "telephone_number": "561-741-1316",
            "fax_number": "561-741-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 W INDIANTOWN RD",
            "address_2": "SUITE 11",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334586813",
            "telephone_number": "561-741-1316",
            "fax_number": "561-741-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSTROM",
        "first_name": "CHRISTIAN",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381212000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CH7662",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; 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.