Individual provider Active NPI

Kaitlyn Martin-Edwards, DC

  • Chiropractor
  • Longwood, FL
National Provider Identifier
1417754144
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH15360 Issued in FL
Practice address
351 N Ronald Reagan Blvd Ste 1015
Longwood, FL 32750-4159
Phone
(407) 417-2533
NPI assigned
Feb 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH15360 FL Primary

Addresses

Primary practice location

351 N Ronald Reagan Blvd Ste 1015
Longwood, FL 32750-4159

Mailing address

1004 Berkman Cir FL 32771USA
Sanford, FL 32771-6309
Phone (912) 409-2009

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CH15360FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
P.H.I.T. Performance Health & Integrative Training Chiropractor CurrentSince Apr 20, 2025 Accepting new patients

Locations

351 N Ronald Reagan Blvd
Ste 1015
Longwood, FL 32750
Phone (407) 417-2533

Organizations & group practices 1

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": "1740700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1417754144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 BERKMAN CIR FL 32771USA",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327716309",
            "telephone_number": "912-409-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 N RONALD REAGAN BLVD STE 1015",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504159",
            "telephone_number": "407-417-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN-EDWARDS",
        "first_name": "KAITLYN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-28",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH15360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.