Individual provider Active NPI

Hannibal Hervey, D.C.

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1508155052
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10285 Issued in FL
Practice address
10981 Countryway Blvd.
Tampa, FL 33626
Phone
(585) 690-9289
Fax
(585) 690-9289
NPI assigned
Apr 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH10285 FL Primary

Addresses

Primary practice location

10981 Countryway Blvd.
Tampa, FL 33626

Mailing address

10981 Countryway Blvd
Apt 1
Tampa, FL 33626-2630
Phone (585) 690-9289

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240226003889 VA Practitioner - Chiropractic 8022453307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Om the Center for Well Being, P.C.Group PAC ID 5799135349, 3 clinicians

Practice addresses (Care Compare)

11 W Market St
Suite 201
Leesburg, VA 20176-2923
Phone 70372498992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH10285FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Om: the Center for Well Being, P.C. Chiropractor CurrentSince Jan 2, 2024 Accepting new patients
Sosa Family Chiropractic Center PA Chiropractor Past Accepting new patients
Serrano Chiropractic Services Chiropractor Past Accepting new patients

Locations

21785 Filigree Ct
Ste 200
Ashburn, VA 20147
Phone (703) 724-9899

11 W Market St
Ste 201
Leesburg, VA 20176
Phone (703) 724-9899

Organizations & group practices 3

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": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1508155052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10981 COUNTRYWAY BLVD",
            "address_2": "APT 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336262630",
            "telephone_number": "585-690-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10981 COUNTRYWAY BLVD.",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33626",
            "telephone_number": "585-690-9289",
            "fax_number": "585-690-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERVEY",
        "first_name": "HANNIBAL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.