Individual provider Active NPI

Shane E Sikes, DC

  • Chiropractor
  • Lady Lake, FL
National Provider Identifier
1386024743
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH11456 Issued in FL
Practice address
809 CR 466
C-301
Lady Lake, FL 32159-3215
Phone
(352) 732-5590
NPI assigned
Jun 1, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH11456 FL Primary

Addresses

Primary practice location

809 CR 466
C-301
Lady Lake, FL 32159-3215

Mailing address

1541 SE 17 St
Lake City Spine & Injury
Ocala, FL 34471
Phone (386) 754-2821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH11456FLMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1386024743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 SE 17 ST",
            "address_2": "LAKE CITY SPINE & INJURY",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "34471",
            "telephone_number": "386-754-2821",
            "fax_number": "386-438-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 CR 466",
            "address_2": "C-301",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593215",
            "telephone_number": "352-732-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIKES",
        "first_name": "SHANE",
        "middle_name": "E",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; 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.