Individual provider Active NPI

Tige R Buchanan, D.C.

  • Chiropractor
  • Leesburg, FL
National Provider Identifier
1417989658
Registry record updated Jul 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8193 Issued in FL
Practice address
32815 Radio Rd
Leesburg, FL 34788-3902
Phone
(352) 787-8531
Fax
(352) 787-3041
NPI assigned
Jul 7, 2006
Last updated
Jul 13, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH8193 FL Primary

Addresses

Primary practice location

32815 Radio Rd
Leesburg, FL 34788-3902

Mailing address

9836 US Highway 441
Leesburg, FL 34788-7273
Phone (352) 787-8531

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060424000595 FL Practitioner - Chiropractic 4082624895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buchanan Physical Medicine, Inc.Group PAC ID 1153609441, 4 clinicians

Practice addresses (Care Compare)

9836 US Hwy 441
Leesburg, FL 34788-3918
Phone (352) 787-8531

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH8193FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Buchanan Physical Medicine, Inc CurrentSince Dec 1, 2015 Accepting new patients

Locations

9836 US Highway 441
Leesburg, FL 34788
Phone (352) 787-8531

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cornerstone HospiceTavares, FL, CCN 101525 Hospice Corporate Director Sep 30, 2015
Cornerstone Hospice and Palliative Care of Georgia, LLCMarietta, GA, CCN 851526 Hospice Corporate Officer
Corporate Director
Jun 12, 2024
Jun 12, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499904000000",
    "number": "1417989658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9836 US HIGHWAY 441",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347887273",
            "telephone_number": "352-787-8531",
            "fax_number": "352-787-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32815 RADIO RD",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347883902",
            "telephone_number": "352-787-8531",
            "fax_number": "352-787-3041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "TIGE",
        "middle_name": "R",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2017-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.