Individual provider Active NPI

Kelley Dianne Chick, DC

  • Chiropractor
  • Daytona Beach, FL
National Provider Identifier
1386576338
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH15984 Issued in FL
Practice address
1890 Lpga Blvd Ste 140
Daytona Beach, FL 32117-7131
Phone
(386) 947-7185
NPI assigned
Jun 2, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH15984 FL Primary

Addresses

Primary practice location

1890 Lpga Blvd Ste 140
Daytona Beach, FL 32117-7131

Mailing address

1890 Lpga Blvd Ste 140
Daytona Beach, FL 32117-7131
Phone (386) 947-7185

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260624002899 FL Practitioner - Chiropractic 2365915063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5400 Coraci Blvd
Apt 10109
Port Orange, FL 32128-7209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH15984FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Passion Chiropractic LLC Chiropractor CurrentSince Jun 16, 2026 Accepting new patients

Locations

3510 S Nova Rd
Ste 111
Port Orange, FL 32129
Phone (386) 310-9401

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1780358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1386576338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD STE 140",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177131",
            "telephone_number": "386-947-7185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD STE 140",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177131",
            "telephone_number": "386-947-7185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHICK",
        "first_name": "KELLEY",
        "middle_name": "DIANNE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-02",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH15984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.