Individual provider Active NPI

Joanne Marie Eash, D.C.

  • Rehabilitation Chiropractor
  • Port Orange, FL
National Provider Identifier
1457529745
Registry record updated Apr 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
CH9513 Issued in FL
Practice address
4705 Clyde Morris Blvd
Port Orange, FL 32129-4103
Phone
(386) 763-2718
Fax
(386) 763-2719
NPI assigned
Feb 20, 2008
Last updated
Apr 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 12009 TX
Rehabilitation Chiropractor 111NR0400X CH9513 FL Primary

Addresses

Primary practice location

4705 Clyde Morris Blvd
Port Orange, FL 32129-4103

Mailing address

4705 Clyde Morris Blvd
Port Orange, FL 32129-4103
Phone (386) 763-2718

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090108000263 FL Practitioner - Chiropractic 6901969526 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH9513FLMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Palmer College Foundation CurrentSince Apr 4, 2016 Accepting new patients
Palmer College Foundation CurrentSince Apr 4, 2016 Accepting new patients

Locations

311 N Clyde Morris Blvd
Ste 310
Daytona Beach, FL 32114
Phone (386) 257-6644

4705 Clyde Morris Blvd
Pt Orange, FL 32129
Phone (386) 763-2712

1000 Brady St
Davenport, IA 52803
Phone (563) 884-5800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1457529745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 CLYDE MORRIS BLVD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294103",
            "telephone_number": "386-763-2718",
            "fax_number": "386-763-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 CLYDE MORRIS BLVD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294103",
            "telephone_number": "386-763-2718",
            "fax_number": "386-763-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASH",
        "first_name": "JOANNE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-20",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "12009",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "FL",
            "license": "CH9513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; 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.