South Mandarin Chiropractic and Wellness, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH9481 Issued in FL

Legal business name

SOUTH MANDARIN CHIROPRACTIC AND WELLNESS, INC.

Practice address

11808 San Jose Blvd
Ste. 2
Jacksonville, FL 32223-0754

Phone

(904) 880-3271

Fax

(904) 880-3273

NPI assigned

Feb 4, 2009

Last updated

Apr 8, 2015By 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. Jacob Justin Hutzell, D,C,NPI 1972752822

Title

Owner/Chiropractor

Phone

(904) 880-3271

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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.

• Jacob Justin Hutzell, D.C.

  • Chiropractor
  • Jacksonville, FL
  • NPI 1972752822
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428451200000",
    "number": "1487892030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11808 SAN JOSE BLVD",
            "address_2": "STE. 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322230754",
            "telephone_number": "904-880-3271",
            "fax_number": "904-880-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11808 SAN JOSE BLVD",
            "address_2": "STE. 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322230754",
            "telephone_number": "904-880-3271",
            "fax_number": "904-880-3273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MANDARIN CHIROPRACTIC AND WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-04",
        "last_updated": "2015-04-08",
        "status": "A",
        "authorized_official_last_name": "HUTZELL",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "904-880-3271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D,C,"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Florida Counseling and Awareness Center (Solutions Counseling)
• South Jacksonville Dental PLLC (Aspen Dental)
• South Jacksonville FL Caregiving LLC (Cornerstone Caregiving)
• South Jacksonville FL Opco LLC (University Center for Nursing and Healing)
• South Mandarin Chiropractic & Wellness
• South Rehabilitation Center, Inc.
• Catherine Nicole South
• Matthew Travis South
• Cathleen Helena Southall, ARNP
• Southbrdge Health and Wellness LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; 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.