Kenneth Thomas Mack, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH8704 Issued in FL

Practice address

1525 S Alafaya TRL
Suite 102
Orlando, FL 32828-8926

Phone

(321) 236-8452

NPI assigned

Jan 30, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mauricio Chiropractic East Colonial, LLCGroup PAC ID 4385723451, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Mauricio Chiropractic East Colonial, LLC

  • Chiropractor
  • Orlando, FL
  • NPI 1245413459
  Medicare reassignment Care Compare group NPD
• Mauricio Chiropractic Clinics PA

  • Chiropractor
  • Orlando, FL
  • NPI 1992988109
  Medicare reassignment NPD
• Mauricio Chiropractic Dr. Phillips, LLC

  • Chiropractor
  • Orlando, FL
  • NPI 1396110110
  Medicare reassignment NPD
• Mauricio Chiropractic Group Inc

  • Chiropractor
  • Orlando, FL
  • NPI 1629258330
  Medicare reassignment NPD
• Mauricio Chiropractic Poinciana LLC

  • Chiropractor
  • Kissimmee, FL
  • NPI 1477739258
  Medicare reassignment NPD
• Mauricio Chiropractic South L L C

  • Chiropractor
  • Orlando, FL
  • NPI 1689870412
  Medicare reassignment NPD
• Peak Health and Wellness, P.a.

  • Clinic/Center
  • Orlando, FL
  • NPI 1023476504
  NPD (past) Authorized official
• Mauricio Chiropractic Clinics PA

  • Chiropractor
  • Winter Park, FL
  • NPI 1982884698
  NPD
• Sparlin Healthcare

  • Clinic/Center
  • Atlanta, GA
  • NPI 1124567201
  NPD (past)

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1437336641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 S ALAFAYA TRL",
            "address_2": "SUITE 102",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288926",
            "telephone_number": "321-236-8452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 S ALAFAYA TRL",
            "address_2": "SUITE 102",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288926",
            "telephone_number": "321-236-8452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "KENNETH",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-30",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP NUMBER",
            "identifier": "1780703397",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane A. Maciejewski, PHARMD.
• Bradley Eric Mack
• Gabriel Mack
• Jacqueline D Mack
• Jenaye Lindsey Mack, MD
• Lillian Christine Mack, APRN
• Lydia Ruth Mack, PT, DPT
• Rene Saadia Kerice Mack, MD
• Megan Elise Mackellar
• Paige Mackenzie, PA

• Chiropractor in Orlando, FL
• Providers in Orlando, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.