Organization Active NPI

Lake Mary Chiropractic Center PA

  • Chiropractor
  • Lake Mary, FL
National Provider Identifier
1376729525
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7869 Issued in FL
Legal business name
LAKE MARY CHIROPRACTIC CENTER PA
Practice address
3240 W Lake Mary Blvd
Ste. 1300
Lake Mary, FL 32746-3583
Phone
(407) 302-5161
NPI assigned
Jan 18, 2008
Last updated
Mar 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Authorized official

Name
Paul Toma, DCNPI 1760518419
Title
President
Phone
(407) 302-5161

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 CH7869 FL Primary

Addresses

Primary practice location

3240 W Lake Mary Blvd
Ste. 1300
Lake Mary, FL 32746-3583

Mailing address

3240 W Lake Mary Blvd
Ste. 1300
Lake Mary, FL 32746-3583
Phone (407) 302-5161

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040921001357 FL Part B Supplier - Clinic/Group Practice 4688642291 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Mary, FL

National Provider Directory

National Provider Directory

Locations

3240 W Lake Mary Blvd
Ste 1300
Lake Mary, FL 32746
Phone (407) 302-5161

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1376729525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 W LAKE MARY BLVD",
            "address_2": "STE. 1300",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463583",
            "telephone_number": "407-302-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 W LAKE MARY BLVD",
            "address_2": "STE. 1300",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463583",
            "telephone_number": "407-302-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MARY CHIROPRACTIC CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "TOMA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-302-5161",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.