Individual provider Active NPI

Alex David Keith, DC CCSP

  • Chiropractor
  • Lake Worth, FL
National Provider Identifier
1386610616
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6682 Issued in FL
Practice address
1814 N Federal Hwy
Lake Worth, FL 33460
Phone
(561) 582-2225
Fax
(561) 582-6358
NPI assigned
Feb 27, 2006
Last updated
Mar 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH6682 FL Primary

Addresses

Primary practice location

1814 N Federal Hwy
Lake Worth, FL 33460

Mailing address

1814 N Federal Hwy
Lake Worth, FL 33460
Phone (561) 582-2225

Other identifiers 2

IdentifierTypeStateIssuer
1386610616OtherFLNPI
1043231129OtherFLNPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111219000783 FL Practitioner - Chiropractic 0446424071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1814 N Federal Hwy
Lake Worth, FL 33460-6641
Phone (561) 582-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH6682FLMDChiropractor
6682FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Wellness Centers Inc Chiropractor CurrentSince Jan 4, 1994 Accepting new patients

Locations

1814 N Federal Hwy
Lake Worth Beach, FL 33460
Phone (561) 582-2225

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1386610616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 N FEDERAL HWY",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33460",
            "telephone_number": "561-582-2225",
            "fax_number": "561-582-6358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 N FEDERAL HWY",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33460",
            "telephone_number": "561-582-2225",
            "fax_number": "561-582-6358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "ALEX",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DC CCSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1386610616",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1043231129",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.