Organization Active NPI

Tyler Darl Albrecht D.C., P.a.

Doing business as St. Augustine Spine Center

  • Chiropractor
  • St Augustine, FL
National Provider Identifier
1457630063
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9751 Issued in FL
Legal business name
TYLER DARL ALBRECHT D.C., P.A.
Doing business as
St. Augustine Spine Center
Practice address
1750 Tree Blvd Ste 8
St Augustine, FL 32084-5719
Phone
(904) 429-7750
Fax
(904) 429-7664
NPI assigned
Aug 12, 2011
Last updated
Feb 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Authorized official

Name
Dr. Tyler Darl Albrecht, D.C.NPI 1982937173
Title
Owner
Phone
(904) 429-7750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9751 FL Primary

Addresses

Primary practice location

1750 Tree Blvd Ste 8
St Augustine, FL 32084-5719

Mailing address

1750 Tree Blvd Ste 8
St Augustine, FL 32084-5719
Phone (904) 429-7750

Other names 1

  • St. Augustine Spine Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111003000046 FL Part B Supplier - Clinic/Group Practice 8729250477 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Augustine, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1457630063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 TREE BLVD STE 8",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845719",
            "telephone_number": "904-429-7750",
            "fax_number": "904-429-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 TREE BLVD STE 8",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845719",
            "telephone_number": "904-429-7750",
            "fax_number": "904-429-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER DARL ALBRECHT D.C., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-12",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "ALBRECHT",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "DARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-429-7750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Augustine Spine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.