Individual provider Active NPI

Jenna Lynn Langenderfer, D.C.

  • Chiropractor
  • Palm Coast, FL
National Provider Identifier
1417492075
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 11994 Issued in FL
Practice address
1 Florida Park Dr N
Ste 106
Palm Coast, FL 32137-3843
Phone
(386) 603-8001
Fax
(386) 603-4111
NPI assigned
Jan 5, 2017
Last updated
Nov 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 11994 FL Primary

Addresses

Primary practice location

1 Florida Park Dr N
Ste 106
Palm Coast, FL 32137-3843

Mailing address

1 Florida Park Dr N Ste 106
Palm Coast, FL 32137-3843
Phone (386) 603-8001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170721001443 FL Practitioner - Chiropractic 9234409384 Reassigns benefits to 1 organization
Practice locations: Flagler Beach, FL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
On Point Chiropractic LLCGroup PAC ID 3274885652, 2 clinicians

Practice addresses (Care Compare)

1 Florida Park Dr S
Suite 106
Palm Coast, FL 32137-3801
Phone (386) 603-8001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 11994FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
On Point Chiropractic LLC Chiropractor CurrentSince Oct 31, 2019 Accepting new patients
Flagler Chiropractic PA Chiropractor Past Accepting new patients

Locations

1 Florida Park Dr N
Ste 106
Palm Coast, FL 32137
Phone (386) 603-8001

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1417492075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FLORIDA PARK DR N STE 106",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373843",
            "telephone_number": "386-603-8001",
            "fax_number": "386-603-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FLORIDA PARK DR N",
            "address_2": "STE 106",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373843",
            "telephone_number": "386-603-8001",
            "fax_number": "386-603-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGENDERFER",
        "first_name": "JENNA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-05",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 11994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; 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.