Organization Active NPI

The Headache Clinic

  • Clinic/Center
  • Chuluota, FL
National Provider Identifier
1386366763
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
THE HEADACHE CLINIC
Practice address
1942 W County Road 419 Ste 1050
Chuluota, FL 32766-9024
Phone
(321) 451-2576
Fax
(407) 255-2361
NPI assigned
Sep 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Authorized official

Name
Mr. Aamir Shahid Khattak
Title
Credentialing Manager
Phone
(800) 000-0000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1942 W County Road 419 Ste 1050
Chuluota, FL 32766-9024

Mailing address

1942 W County Road 419 Ste 1050
Chuluota, FL 32766-9024
Phone (321) 451-2576

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221108000074 FL Part B Supplier - Clinic/Group Practice 6002283850 Receives reassigned benefits from 1 practitioner
Practice locations: Oviedo, FL

National Provider Directory

National Provider Directory

Locations

1942 W County Road 419
Ste 1050
Chuluota, FL 32766
Phone (321) 451-2576

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": "1663027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701388800000",
    "number": "1386366763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1942 W COUNTY ROAD 419 STE 1050",
            "city": "CHULUOTA",
            "state": "FL",
            "postal_code": "327669024",
            "telephone_number": "321-451-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 W COUNTY ROAD 419 STE 1050",
            "city": "CHULUOTA",
            "state": "FL",
            "postal_code": "327669024",
            "telephone_number": "321-451-2576",
            "fax_number": "407-255-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HEADACHE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-13",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A",
        "authorized_official_last_name": "KHATTAK",
        "authorized_official_first_name": "AAMIR",
        "authorized_official_middle_name": "SHAHID",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "800-000-0000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chuluota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; 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.