Individual provider Active NPI

John Damrath, DC

  • Chiropractor
  • Deland, FL
National Provider Identifier
1447901574
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH23860 Issued in FL
Practice address
905 N Stone St
Deland, FL 32720-2521
Phone
(386) 734-9995
Fax
(386) 734-9949
NPI assigned
Jan 11, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH23860 FL Primary

Addresses

Primary practice location

905 N Stone St
Deland, FL 32720-2521

Mailing address

905 N Stone St
Deland, FL 32720-2521
Phone (386) 734-9995

Other identifiers 1

IdentifierTypeStateIssuer
CH13860OtherFLCHIROPRACTIC LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL PayDC Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220204001535 FL Practitioner - Chiropractic 3072906577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeremy M Gordon DC PAGroup PAC ID 7911927041, 4 clinicians

Practice addresses (Care Compare)

905 N Stone St
Deland, FL 32720-2521
Phone (386) 734-9995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH23860FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Jeremy M Gordon DC PA CurrentSince Feb 2, 2022 Accepting new patients

Locations

905 N Stone St
Deland, FL 32720
Phone (386) 341-6948

Organizations & group practices 1

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": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1447901574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202521",
            "telephone_number": "386-734-9995",
            "fax_number": "386-734-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202521",
            "telephone_number": "386-734-9995",
            "fax_number": "386-734-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMRATH",
        "first_name": "JOHN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH23860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "CH13860",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "PayDC",
            "affiliation": "N",
            "endpointDescription": "PayDC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "PayDC",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "electronic",
            "address_1": "905 N Stone St",
            "city": "Deland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327202521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.