Organization Active NPI

Romans 12 Two PLLC

  • Chiropractor
  • Mount Dora, FL
National Provider Identifier
1487242137
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ROMANS 12 TWO PLLC
Practice address
2255 Crescent Dr
Mount Dora, FL 32757-4708
Phone
(352) 720-3672
NPI assigned
Jan 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Authorized official

Name
Dr. Todd Gignac, DCNPI 1548322944
Title
Director/Chiropractor
Phone
(352) 720-3672

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2255 Crescent Dr
Mount Dora, FL 32757-4708

Mailing address

2255 Crescent Dr
Mount Dora, FL 32757-4708

Other names 1

  • Mount Dora Family Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210208002038 FL Part B Supplier - Clinic/Group Practice 3678988466 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Dora, FL

National Provider Directory

National Provider Directory

Locations

2255 Crescent Dr
Mount Dora, FL 32757
Phone (352) 383-3826

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612137600000",
    "number": "1487242137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 CRESCENT DR",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327574708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 CRESCENT DR",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327574708",
            "telephone_number": "352-720-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROMANS 12 TWO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A",
        "authorized_official_last_name": "GIGNAC",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "DIRECTOR/CHIROPRACTOR",
        "authorized_official_telephone_number": "352-720-3672",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mount Dora Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mount Dora Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Dora, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.