Port St. Joe Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PORT ST. JOE CHIROPRACTIC, LLC

Practice address

16910 S US Highway 441
Summerfield, FL 34491-8664

Phone

(850) 960-8118

Fax

(352) 347-9044

NPI assigned

Apr 2, 2008

Organization subpart

No

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

Authorized official

Name

Douglas Altman, D.C.

Title

Owner/Chiropractor

Phone

(850) 960-8118

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

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

• Nancy Kay Nichols

  • Reflexologist
  • Summerfield, FL
  • NPI 1144497058
  NPD (past)

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402531200000",
    "number": "1497928121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16910 S US HIGHWAY 441",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344918664",
            "telephone_number": "850-960-8118",
            "fax_number": "352-347-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16910 S US HIGHWAY 441",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344918664",
            "telephone_number": "850-960-8118",
            "fax_number": "352-347-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT ST. JOE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2014-06-12",
        "status": "A",
        "authorized_official_last_name": "ALTMAN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "850-960-8118",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "U85018",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "88546",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381798900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Perspectives II
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• Hope Alicia Pope, LMT
• Pure Sound Hearing Centers, LLC.
• Daniel P Quezada, HOMEMAKER
• Elva Nery Quezada, NURSING ASSISTANT
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• Brittaney Ramsey, LMT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; 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.