Individual provider Active NPI

Edgar Alejandro Rivadeneyra Arzola, DC

  • Chiropractor
  • Bradenton, FL
National Provider Identifier
1437755303
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH13276 Issued in FL
Practice address
8792 State Road 70 E Ste 101
Bradenton, FL 34202-3706
Phone
(941) 756-4362
NPI assigned
Dec 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH13276 FL Primary

Addresses

Primary practice location

8792 State Road 70 E Ste 101
Bradenton, FL 34202-3706

Mailing address

4730 Reisswood Loop
Palmetto, FL 34221-1316
Phone (787) 549-4139

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210105002117 FL Practitioner - Chiropractic 2769895044 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH13276FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
North Tampa Spine & Joint Center LLC CurrentSince Jan 4, 2021 Accepting new patients
Manatee Wellness & Chiropractic Centers, Inc CurrentSince Jan 22, 2023 Accepting new patients

Locations

8792 State Road 70 E
Ste 101
Bradenton, FL 34202
Phone (727) 560-1150

8405 US Highway 301 N
Ste 104
Parrish, FL 34219
Phone (727) 560-1150

17429 Bridge Hill Ct
Tampa, FL 33647
Phone (813) 893-7921

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1437755303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 REISSWOOD LOOP",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342211316",
            "telephone_number": "787-549-4139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8792 STATE ROAD 70 E STE 101",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342023706",
            "telephone_number": "941-756-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVADENEYRA ARZOLA",
        "first_name": "EDGAR",
        "middle_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-07",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.