Individual provider Active NPI

Bernardita Prado, D.C.

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1538307186
Registry record updated Jun 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 9667 Issued in FL
Practice address
4111 Atlantic Blvd
Jacksonville, FL 32207-2038
Phone
(904) 372-3764
NPI assigned
Feb 4, 2009
Last updated
Jun 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 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 CH 9667 FL Primary

Addresses

Primary practice location

4111 Atlantic Blvd
Jacksonville, FL 32207-2038

Mailing address

2396 Edgewood Ave N
Jacksonville, FL 32254-1725
Phone (904) 781-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 9667FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Associates of Ocala Inc Chiropractor PastSince Nov 2, 2017 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464998400000",
    "number": "1538307186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2396 EDGEWOOD AVE N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322541725",
            "telephone_number": "904-781-2300",
            "fax_number": "904-781-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072038",
            "telephone_number": "904-372-3764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADO",
        "first_name": "BERNARDITA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2016-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 9667",
            "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 Jun 4, 2016; 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.