NPIMap

Organization Active NPI

Chiropractic USA of Buffalo Ridge Inc

  • Chiropractor
  • The Villages, FL
National Provider Identifier
1568776276
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH5257 Issued in FL
Legal business name
CHIROPRACTIC USA OF BUFFALO RIDGE INC
Practice address
3614 Wedgewood LN
The Villages, FL 32162-9318
Phone
(352) 259-2225
Fax
(352) 259-4411
NPI assigned
Aug 5, 2010
Last updated
Aug 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Authorized official

Name
Dr. Renny M Edelson, D.C.NPI 1740222710
Title
Chiropractor/Owner
Phone
(954) 270-2884

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
Chiropractor 111N00000X CH5257 FL Primary

Addresses

Primary practice location

3614 Wedgewood LN
The Villages, FL 32162-9318

Mailing address

7668 S.W. 60TH Avenue
Suite 500
Ocala, FL 34476-6404
Phone (352) 351-2872

Other identifiers 1

IdentifierTypeStateIssuer
000ZGOtherFLBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101028001059 FL Part B Supplier - Clinic/Group Practice 6103010616 Receives reassigned benefits from 3 practitioners
Practice locations: The Villages, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1280966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1568776276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7668 S.W. 60TH AVENUE",
            "address_2": "SUITE 500",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344766404",
            "telephone_number": "352-351-2872",
            "fax_number": "352-351-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 WEDGEWOOD LN",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321629318",
            "telephone_number": "352-259-2225",
            "fax_number": "352-259-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC USA OF BUFFALO RIDGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-05",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "EDELSON",
        "authorized_official_first_name": "RENNY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "954-270-2884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH5257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000ZG",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.