Hodges Beach Physical Rehabilitation PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH8853 Issued in FL

Legal business name

HODGES BEACH PHYSICAL REHABILITATION PLLC

Practice address

13947 Beach Blvd Ste 202
Jacksonville, FL 32224-1200

Phone

(904) 223-3330

Fax

(904) 223-4560

NPI assigned

Nov 19, 2009

Organization subpart

No

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

Authorized official

Name

Richard Ray Bloom Sr., D.C.

Title

Owner/Chiropractor

Phone

(904) 223-3330

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1528396199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13947 BEACH BLVD STE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241200",
            "telephone_number": "904-223-3330",
            "fax_number": "904-223-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13947 BEACH BLVD STE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241200",
            "telephone_number": "904-223-3330",
            "fax_number": "904-223-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HODGES BEACH PHYSICAL REHABILITATION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-19",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "904-223-3330",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelby R Hoden, RBT
• Gerard Romelo Hodge-Rocourt
• Alissa Hodge, LCSW
• April Ebony Hodge
• Kassidy Hodge
• Hodges Physical Medicine LLP
• Blake William Hodges, DO
• Cidney Tabatha Hodges, MA
• Deanna M Hodges, O.T.
• Freda Hodges, M.S.W.

• 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 Nov 19, 2009; 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.