Orange Park Chiropractic Center PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH 7619 Issued in FL

Legal business name

ORANGE PARK CHIROPRACTIC CENTER PA

Practice address

868 Blanding Blvd
Suite 128
Orange Park, FL 32065

Phone

(904) 272-4555

Fax

(904) 276-2521

NPI assigned

Dec 15, 2006

Last updated

Apr 8, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Keith Allen Schertell, DCNPI 1902803018

Title

President Physician

Phone

(904) 272-4555

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keith Allen Schertell, D.C.

  • Chiropractor
  • Orange Park, FL
  • NPI 1902803018
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302220800000",
    "number": "1366504003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 BLANDING BLVD",
            "address_2": "SUITE 128",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320658942",
            "telephone_number": "904-272-4555",
            "fax_number": "904-276-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "868 BLANDING BLVD",
            "address_2": "SUITE 128",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32065",
            "telephone_number": "904-272-4555",
            "fax_number": "904-276-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE PARK CHIROPRACTIC CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2011-04-08",
        "status": "A",
        "authorized_official_last_name": "SCHERTELL",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT PHYSICIAN",
        "authorized_official_telephone_number": "904-272-4555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 7619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381197200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Optimum Care & Training
• Orange Park Acute Trauma,LLC
• Orange Park Adult Day Center, LLC
• Orange Park Assisted Living Facility, Inc.
• Orange Park Audiology Clinic
• Orange Park Dentistry
• Orange Park Endoscopy Center LLC
• Orange Park Extended Care LLC (The Terrace At Fleming Island)
• Orange Park Facility Operations LLC (Orange Park Health and Rehabilitation)
• Orange Park FL Opco LLC (Orange Park Center for Nursing and Healing)

• Chiropractor in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; 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.