Organization Active NPI

Kingdom Medical Group

Doing business as Kingdom Chiropractic

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1457012585
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KINGDOM MEDICAL GROUP
Doing business as
Kingdom Chiropractic
Practice address
501 S Falkenburg Rd Ste A2
Tampa, FL 33619-8040
Phone
(813) 434-1045
Fax
(813) 434-1259
NPI assigned
Dec 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Dr. Fredrick Thomas Williams
Title
Ceo
Phone
(813) 434-1045

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

501 S Falkenburg Rd Ste A2
Tampa, FL 33619-8040

Mailing address

501 S Falkenburg Rd Ste A2
Tampa, FL 33619-8040
Phone (813) 434-1045

Other names 1

  • KINGDOM CHIROPRACTIC Doing business as

National Provider Directory

National Provider Directory

Locations

501 S Falkenburg Rd
Ste C23
Tampa, FL 33619

501 S Falkenburg Rd
Ste A2
Tampa, FL 33619
Phone (813) 434-1045

NPI Registry JSON

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1457012585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S FALKENBURG RD STE A2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336198040",
            "telephone_number": "813-434-1045",
            "fax_number": "813-434-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S FALKENBURG RD STE A2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336198040",
            "telephone_number": "813-434-1045",
            "fax_number": "813-434-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-30",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "FREDRICK",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-434-1045",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KINGDOM CHIROPRACTIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.