Organization Active NPI

Harrison R Todd II DC PLC

  • Chiropractor
  • Vero Beach, FL
National Provider Identifier
1538354808
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH5790 Issued in FL
Legal business name
HARRISON R TODD II DC PLC
Practice address
1703 24TH St
Vero Beach, FL 32960-3351
Phone
(772) 562-2053
Fax
(772) 562-8197
NPI assigned
Sep 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Authorized official

Name
Harrison Rogers Todd II, D.C.NPI 1194855775
Title
Managing Member
Phone
(772) 562-2053

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 CH5790 FL Primary

Addresses

Primary practice location

1703 24TH St
Vero Beach, FL 32960-3351

Mailing address

1703 24TH St
Vero Beach, FL 32960-3351
Phone (772) 562-2053

Other identifiers 1

IdentifierTypeStateIssuer
22212OtherFLBLUE CROSS BLUE SHIELD OF

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080110000425 FL Part B Supplier - Clinic/Group Practice 2567542921 Receives reassigned benefits from 1 practitioner
Practice locations: Vero Beach, FL

National Provider Directory

National Provider Directory

Locations

1703 24th St
Vero Beach, FL 32960
Phone (407) 562-2053

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1538354808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 24TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329603351",
            "telephone_number": "772-562-2053",
            "fax_number": "772-562-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 24TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329603351",
            "telephone_number": "772-562-2053",
            "fax_number": "772-562-8197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRISON R TODD II DC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "TODD",
        "authorized_official_first_name": "HARRISON",
        "authorized_official_middle_name": "ROGERS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "772-562-2053",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH5790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "22212",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.