Columbia County Chiropractic Center, LLC

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

CH5141 Issued in FL

Legal business name

COLUMBIA COUNTY CHIROPRACTIC CENTER, LLC

Doing business as

Darrel Thomas Mathis

Practice address

279 SW Main Blvd
Lake City, FL 32025-7050

Phone

(386) 752-4313

Fax

(386) 752-8356

NPI assigned

Jul 18, 2007

Last updated

Mar 24, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Darrel Thomas Mathis, D.C.NPI 1679571822

Title

Owner/Physician

Phone

(386) 752-4313

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Darrel Thomas Mathis Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 5

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.

• Darrel Thomas Mathis, D.C.,F.A.C.O.

  • Orthopedic Chiropractor
  • Lake City, FL
  • NPI 1679571822
  Medicare reassignment Authorized official
• Julie Floyd, LMT

  • Massage Therapist
  • Lake City, FL
  • NPI 1578356861
  NPD
• Shannon Thomas

  • Massage Therapist
  • Lake City, FL
  • NPI 1265149231
  NPD
• David Bates Morse, D.C.

  • Chiropractor
  • Lake City, FL
  • NPI 1437147261
  NPD (past)
• Shawn A Stephens, DC

  • Chiropractor
  • Lake City, FL
  • NPI 1356481386
  NPD (past)

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490313600000",
    "number": "1467652578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320257050",
            "telephone_number": "386-752-4313",
            "fax_number": "386-752-8356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320257050",
            "telephone_number": "386-752-4313",
            "fax_number": "386-752-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA COUNTY CHIROPRACTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2017-03-24",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "DARREL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "386-752-4313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "FL",
            "license": "CH5141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "CL2214",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "050782200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Darrel Thomas Mathis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Lyn Collins, L.M.T.
• Anita Nicole Collins
• Doris F Collins
• Joanne Collins
• Adrianne Leigh Cology, LMHC
• Columbia County Emergency Medical Services
• Columbia County School District
• Columbia County School District
• Columbia County School District
• Columbia County School District

• Orthopedic Chiropractor in Lake City, FL
• Providers in Lake City, FL by specialty
• Orthopedic Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; 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.