Lake City Spine & Injury, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH9403 Issued in FL

Legal business name

LAKE CITY SPINE & INJURY, LLC

Practice address

2057 SW Main Blvd
Lake City, FL 32025-0021

Phone

(386) 438-5524

NPI assigned

Apr 7, 2016

Organization subpart

Yes

Parent organization

LAKE CITY SPINE & INJURY, LLCAs reported in NPPES

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

Authorized official

Name

Jonathan Walker, D.C.

Title

Owner

Phone

(386) 438-5524

Specialties & licenses 1

Addresses

Part of

Lake City Spine Injury LLC

Locations

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459987200000",
    "number": "1487018222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2057 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250021",
            "telephone_number": "386-438-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2057 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250021",
            "telephone_number": "386-438-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CITY SPINE & INJURY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKE CITY SPINE & INJURY, LLC",
        "enumeration_date": "2016-04-07",
        "last_updated": "2016-04-07",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-438-5524",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake City Outpatient Anesthesia PLLC
• Lake City Outpatient Anesthesia PLLC
• Lake City Pharmacy Inc
• Lake City Regional Medical Group LLC
• Lake City Rehab LLC
• Lake City Surgery Center, LLC
• Lake City Veteran'S Hospital
• Lake City Vision PA
• Lake Citytherapeutic LLC
• Lake Shore Center for Aesthetics & Plastic Surgery PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; 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.