Organization Active NPI

My Chiropractor of South Daytona Inc

  • Chiropractor
  • South Daytona, FL
National Provider Identifier
1396990529
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MY CHIROPRACTOR OF SOUTH DAYTONA INC
Practice address
915 Big Tree Rd
South Daytona, FL 32119-2517
Phone
(386) 756-0934
NPI assigned
Dec 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Authorized official

Name
Dr. Jill D. Gerard, D.C.
Title
Doctor/Business Owner
Phone
(386) 756-0934

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

915 Big Tree Rd
South Daytona, FL 32119-2517

Mailing address

915 Big Tree Rd
South Daytona, FL 32119-2517
Phone (386) 756-0934

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1396990529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 BIG TREE RD",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321192517",
            "telephone_number": "386-756-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 BIG TREE RD",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321192517",
            "telephone_number": "386-756-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY CHIROPRACTOR OF SOUTH DAYTONA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-02",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "GERARD",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "DOCTOR/BUSINESS OWNER",
        "authorized_official_telephone_number": "386-756-0934",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.