Intercoastal Chiropractic Clinic PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH0007521 Issued in FL

Legal business name

INTERCOASTAL CHIROPRACTIC CLINIC PA

Practice address

14255 Beach Blvd Ste a
Jacksonville, FL 32250-1545

Phone

(904) 223-1616

NPI assigned

Jan 23, 2008

Organization subpart

No

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

Authorized official

Name

Joyce Tucker

Title

Billing Manager

Phone

(904) 272-3440

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280880000000",
    "number": "1457538266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14255 BEACH BLVD STE A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322501545",
            "telephone_number": "904-223-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14255 BEACH BLVD STE A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322501545",
            "telephone_number": "904-223-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERCOASTAL CHIROPRACTIC CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2010-08-04",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "904-272-3440"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0007521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrative Psychiatric Solutions, LLC (The Practice)
• Integrity Home Care Services LLC
• Integrity Spine and Orthopedics LLC
• Intentional Play, Inc (Intentional Play Pediatric Therapy Services)
• Intercede Physical Therapy
• Intercoastal Health
• Internal Medical Group, Inc.
• Internal Medicine Associates of Jacksonville P a
• Internal Medicine Associates of Jacksonville, Gary a. Decker, MD, PA
• Internal Medicine of Jacksonville

• Chiropractor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.