Individual provider Active NPI

John Bradley Deiner, D.C.

  • Chiropractor
  • Fort Pierce, FL
National Provider Identifier
1386746428
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8497 Issued in FL
Practice address
805 Virginia Ave Ste 10
Fort Pierce, FL 34982-5881
Phone
(772) 460-9000
Fax
(772) 460-6697
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH8497 FL Primary

Addresses

Primary practice location

805 Virginia Ave Ste 10
Fort Pierce, FL 34982-5881

Mailing address

805 Virginia Ave Ste 10
Fort Pierce, FL 34982-5881
Phone (772) 460-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070524000690 FL Practitioner - Chiropractic 8325092844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ocean Chiropractic and Health Center IncGroup PAC ID 8527012020, 4 clinicians

Practice addresses (Care Compare)

805 Virginia Ave
Suite 11
Fort Pierce, FL 34982-5881
Phone (772) 460-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH8497FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Chiropractic & Health Center, Inc. Chiropractor CurrentSince Jan 6, 2005 Accepting new patients
Family Chiropractic Center of Martin County, Inc. Past Accepting new patients

Locations

805 Virginia Ave
Ste 10
Fort Pierce, FL 34982
Phone (561) 972-4645

805 Virginia Ave
Ste 11
Fort Pierce, FL 34982
Phone (772) 460-9000

725 Commerce Center Dr
Ste D
Sebastian, FL 32958

526 SE Dixie Hwy
Stuart, FL 34994
Phone (772) 288-2527

Organizations & group practices 2

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386746428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 VIRGINIA AVE STE 10",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349825881",
            "telephone_number": "772-460-9000",
            "fax_number": "772-460-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 VIRGINIA AVE STE 10",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349825881",
            "telephone_number": "772-460-9000",
            "fax_number": "772-460-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEINER",
        "first_name": "JOHN",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.