Fort Walton Beach Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH8625 Issued in FL

Legal business name

FORT WALTON BEACH CHIROPRACTIC LLC

Practice address

315 Racetrack Rd NE
Fort Walton Beach, FL 32547-2548

Phone

(850) 200-4911

NPI assigned

Sep 13, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Scott Smith, D.C.NPI 1326115825

Title

Manager

Phone

(850) 200-4911

Specialties & licenses 1

Addresses

Other names 1

• Fort Walton Beach Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott Russell Smith, D.C.

  • Chiropractor
  • Fort Walton Beach, FL
  • NPI 1326115825
  Medicare reassignment Authorized official
• Francis Albert Francisco Martin, DC

  • Chiropractor
  • Fort Walton Beach, FL
  • NPI 1316678956
  NPD

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560902400000",
    "number": "1437409885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 RACETRACK RD NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325472548",
            "telephone_number": "850-200-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 RACETRACK RD NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325472548",
            "telephone_number": "850-200-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WALTON BEACH CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-13",
        "last_updated": "2019-06-19",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "850-200-4911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Walton Beach Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniele Foht
• Stefanie Renee Fontaine, BS
• Barbara S. Fontana
• Danielle Fordham
• Fort Walton Beach Anesthesia LLC
• Fort Walton Beach Medical Center, Inc.
• Fort Walton Beach Medical Center, Inc.
• Fort Walton Beach Medical Center, Inc.
• Fort Walton Beach Medical Center, Inc.
• Fort Walton Beach Medical Center, Inc.

• Chiropractor in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; 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.