Andrew Nelson Mayberry, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH13975 Issued in FL

Practice address

4824 Grandview Pkwy
Davenport, FL 33837-2301

Phone

(863) 236-9465

NPI assigned

Mar 3, 2011

Last updated

Mar 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: andrew.mayberry@cccl.eclinicaldirectplus.com

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.

• TCWC Lawrenceville LLC

  • Clinic/Center
  • Lawrenceville, GA
  • NPI 1205212917
  NPD (past)

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1477851269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 GRANDVIEW PKWY",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338372301",
            "telephone_number": "863-236-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 GRANDVIEW PKWY",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338372301",
            "telephone_number": "863-236-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYBERRY",
        "first_name": "ANDREW",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-03",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13975",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008748",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory Marto, OD
• Marvelous Merger Group LLC. (OpenArms)
• John F. Mascia, COTA/L
• Mohammad Reza Mastali, M.D.
• Maxcen Housing Society Inc. (Maxcen Society Humanity Help of Florida)
• Andrea Nichol McDaniel, PHD
• Michelle McDaniel, APRN PMHNP-BC
• Christina McDonald, APRN
• Marcia Michelle McDonald
• Amy Beth McDonnell, PMHNP-BC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.