Organization Active NPI

Indialantic Chiropractic & Acupuncture Inc

  • Chiropractor
  • Indialantic, FL
National Provider Identifier
1437364650
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0004134 Issued in FL
Legal business name
INDIALANTIC CHIROPRACTIC & ACUPUNCTURE INC
Practice address
322 Fourth Avenue
Indialantic, FL 32903
Phone
(321) 727-2225
Fax
(321) 951-8533
NPI assigned
May 11, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Edward G Fleming, DCNPI 1164450029
Title
President
Phone
(321) 727-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0004134 FL Primary

Addresses

Primary practice location

322 Fourth Avenue
Indialantic, FL 32903

Mailing address

322 Fourth Avenue
Indialantic, FL 32903
Phone (321) 727-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070521000131 FL Part B Supplier - Clinic/Group Practice 4880791219 Receives reassigned benefits from 1 practitioner
Practice locations: Indialantic, FL

National Provider Directory

National Provider Directory

Locations

322 4th Ave
Indialantic, FL 32903
Phone (321) 727-2225

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437364650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 FOURTH AVENUE",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "32903",
            "telephone_number": "321-727-2225",
            "fax_number": "321-951-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 FOURTH AVENUE",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "32903",
            "telephone_number": "321-727-2225",
            "fax_number": "321-951-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIALANTIC CHIROPRACTIC & ACUPUNCTURE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-727-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0004134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indialantic, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.