Individual provider Active NPI

Adam Gerard St. Laurent, DC

  • Chiropractor
  • Orlando, FL
National Provider Identifier
1417330168
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH11528 Issued in FL
Practice address
7532 W Sand Lake Rd
Orlando, FL 32819-5110
Phone
(407) 363-0052
Fax
(407) 363-0566
NPI assigned
Jun 30, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH11528 FL Primary

Addresses

Primary practice location

7532 W Sand Lake Rd
Orlando, FL 32819-5110

Mailing address

1550 Wyngate Dr
Deland, FL 32724-7945
Phone (207) 608-0813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1417330168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 WYNGATE DR",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327247945",
            "telephone_number": "207-608-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7532 W SAND LAKE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195110",
            "telephone_number": "407-363-0052",
            "fax_number": "407-363-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. LAURENT",
        "first_name": "ADAM",
        "middle_name": "GERARD",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-30",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; 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.