Individual provider Active NPI

Robert Nathan Fedore, DC

  • Chiropractor
  • Tallahassee, FL
National Provider Identifier
1497715569
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8901 Issued in FL
Practice address
2339 N Monroe St
Tallahassee, FL 32303-4733
Phone
(850) 900-3451
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH8901 FL Primary

Addresses

Primary practice location

2339 N Monroe St
Tallahassee, FL 32303-4733

Mailing address

3758 Laurel Trace Way
Tallahassee, FL 32303-1516
Phone (724) 396-1585

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050620000141 FL Practitioner - Chiropractic 0547204679 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH8901FLMDChiropractor
3704OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Wellness Center of Tallahassee, Inc Chiropractor CurrentSince Apr 2, 2018 Accepting new patients
Healthquest of Fields Ertel Inc Chiropractor Past Accepting new patients

Locations

2339 N Monroe St
Tallahassee, FL 32303
Phone (850) 385-6664

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1497715569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3758 LAUREL TRACE WAY",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323031516",
            "telephone_number": "724-396-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2339 N MONROE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323034733",
            "telephone_number": "850-900-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDORE",
        "first_name": "ROBERT",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.