Jay Chiropractic Center

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

CH0009285 Issued in FL

Legal business name

JAY CHIROPRACTIC CENTER

Practice address

5035 Saints LN
Milton, FL 32570-4046

Phone

(850) 748-0740

Fax

(850) 675-6886

NPI assigned

Feb 7, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Bernard Joseph Keenum, D.C.

Title

Owner/Chiropractic Physician

Phone

(850) 675-6886

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1396017331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3927 HIGHWAY 4",
            "city": "JAY",
            "state": "FL",
            "postal_code": "325651752",
            "telephone_number": "850-675-6886",
            "fax_number": "850-675-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5035 SAINTS LN",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325704046",
            "telephone_number": "850-748-0740",
            "fax_number": "850-675-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-07",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "KEENUM",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "850-675-6886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "FL",
            "license": "CH0009285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF FLORIDA",
            "identifier": "88206",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inward Path LLC
• Iti Agarwal, DDS, P.a.
• Hanna Ivalha, DMD
• Karen Michelle Jackson
• Kiersten Jackson, CLD
• Brooke Jay
• Monica Jemison
• Joseph Jena
• Ashley Jenkins
• Khrysti Danielle Jenkins

• Preferred Provider Organization in Milton, FL
• Providers in Milton, FL by specialty
• Preferred Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.