Organization Active NPI

Dr Doctor Disc Injury and Spinal Care Clinic PA

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1508537234
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DR DOCTOR DISC INJURY AND SPINAL CARE CLINIC PA
Practice address
115 W 8TH St
Jacksonville, FL 32206-3657
Phone
(904) 350-3737
Fax
(844) 373-7329
NPI assigned
Sep 22, 2021
Organization subpart
Yes
Parent organization
DR DOCTOR DISC INJURY AND SPINCAL CARE CLINIC PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Authorized official

Name
Dr. Zeboye Archellq Doctor, DCNPI 1609075373
Title
Ceo
Phone
(904) 350-3737

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

115 W 8TH St
Jacksonville, FL 32206-3657

Mailing address

115 W 8TH St
Jacksonville, FL 32206-3657
Phone (904) 350-3737

Other practice location 1

4103 Moncrief Rd
Jacksonville, FL 32209-3935
Phone (904) 350-3737

National Provider Directory

National Provider Directory
Part of
Dr Doctor Disc Injury and Spinal Care Clinic PA

Locations

4103 Moncrief Rd
Jacksonville, FL 32209
Phone (904) 350-3737

Practitioners & affiliated clinicians

Practitioners 1

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": "1632268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1508537234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322063657",
            "telephone_number": "904-350-3737",
            "fax_number": "844-373-7329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322063657",
            "telephone_number": "904-350-3737",
            "fax_number": "844-373-7329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4103 Moncrief Rd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322093935",
            "country_code": "US",
            "telephone_number": "904-350-3737",
            "fax_number": "904-350-3737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR DOCTOR DISC INJURY AND SPINAL CARE CLINIC PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR DOCTOR DISC INJURY AND SPINCAL CARE CLINIC PA",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "DOCTOR",
        "authorized_official_first_name": "ZEBOYE",
        "authorized_official_middle_name": "ARCHELLQ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-350-3737",
        "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": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.