NPIMap

Organization Active NPI

Affordable Chiropractic Medicine Jacksonville LLC

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1407040868
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0006259 Issued in FL
Legal business name
AFFORDABLE CHIROPRACTIC MEDICINE JACKSONVILLE LLC
Practice address
3546 Saint Johns Bluff Rd S Unit 204
Jacksonville, FL 32224-2716
Phone
(904) 996-2243
Fax
(904) 997-2243
NPI assigned
Aug 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

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

Authorized official

Name
Dr. R.G. Packo, DC
Title
President
Phone
(904) 285-2243

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH0006259 FL Primary

Addresses

Primary practice location

3546 Saint Johns Bluff Rd S Unit 204
Jacksonville, FL 32224-2716

Mailing address

3546 Saint Johns Bluff Rd S Unit 204
Jacksonville, FL 32224-2716
Phone (904) 996-2243

National Provider Directory

National Provider Directory
Tax ID family
Affordable Chiropractic Medicine Jacksonville LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1407040868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3546 SAINT JOHNS BLUFF RD S UNIT 204",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242716",
            "telephone_number": "904-996-2243",
            "fax_number": "904-997-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3546 SAINT JOHNS BLUFF RD S UNIT 204",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242716",
            "telephone_number": "904-996-2243",
            "fax_number": "904-997-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE CHIROPRACTIC MEDICINE JACKSONVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "PACKO",
        "authorized_official_first_name": "R.G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-285-2243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0006259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.