Individual provider Active NPI

Thomas John Nardello Jr., D.C

  • Chiropractor
  • Jensen Beach, FL
National Provider Identifier
1407442445
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH13313 Issued in FL
Practice address
674 NE Jensen Beach Blvd
Jensen Beach, FL 34957
Phone
(772) 334-0034
Fax
(772) 334-0032
NPI assigned
Dec 14, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH13313 FL Primary

Addresses

Primary practice location

674 NE Jensen Beach Blvd
Jensen Beach, FL 34957

Mailing address

674 NE Jensen Beach Blvd
Jensen Beach, FL 34957
Phone (772) 334-0034

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220516001415 FL Practitioner - Chiropractic 2961889878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

674 NE Jensen Beach Blvd
Jensen Beach, FL 34957-4750
Phone (772) 334-0034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH13313FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas J, Nardello, Jr., D.C.,LLC Dba Brown Family Chiropractic Center Chiropractor CurrentSince Apr 11, 2022 Accepting new patients
Dr Randal L Butch DC PA Chiropractor PastSince Dec 1, 2020 Accepting new patients
A Center of Life, Inc. Chiropractor PastSince Nov 26, 2023 Accepting new patients

Locations

674 NE Jensen Beach Blvd
Jensen Beach, FL 34957
Phone (772) 334-0034

Organizations & group practices 3

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": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1407442445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "674 NE JENSEN BEACH BLVD",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "34957",
            "telephone_number": "772-334-0034",
            "fax_number": "772-334-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "674 NE JENSEN BEACH BLVD",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "34957",
            "telephone_number": "772-334-0034",
            "fax_number": "772-334-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARDELLO",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-14",
        "last_updated": "2023-11-22",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jensen Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; 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.