Organization Active NPI

Ottaviani Chiropractic Center LLC

  • Chiropractor
  • Port Orange, FL
National Provider Identifier
1366639163
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
OTTAVIANI CHIROPRACTIC CENTER LLC
Practice address
1515 Herbert St Ste 209
Port Orange, FL 32129-6105
Phone
(386) 366-9119
NPI assigned
Sep 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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

Authorized official

Name
Dr. Andrew Ottaviani, D.C.
Title
President
Phone
(386) 366-9119

Specialties & licenses 1

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

Addresses

Primary practice location

1515 Herbert St Ste 209
Port Orange, FL 32129-6105

Mailing address

1515 Herbert St Ste 209
Port Orange, FL 32129-6105
Phone (386) 366-9119

National Provider Directory

National Provider Directory

Locations

1515 Herbert St
Ste 209
Port Orange, FL 32129
Phone (386) 366-9119

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": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290470400000",
    "number": "1366639163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 HERBERT ST STE 209",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296105",
            "telephone_number": "386-366-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HERBERT ST STE 209",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296105",
            "telephone_number": "386-366-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTAVIANI CHIROPRACTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2010-11-23",
        "status": "A",
        "authorized_official_last_name": "OTTAVIANI",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-366-9119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; 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.