Individual provider Active NPI

Christine Marie Pascual, DC

  • Chiropractor
  • St Augustine, FL
National Provider Identifier
1578007696
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH11859 Issued in FL
Practice address
150 Kent Rd Ste 1a
St Augustine, FL 32086-6485
Phone
(917) 673-6847
Fax
(904) 683-4871
NPI assigned
Dec 8, 2016
Last updated
Oct 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH11859 FL Primary

Addresses

Primary practice location

150 Kent Rd Ste 1a
St Augustine, FL 32086-6485

Mailing address

150 Kent Rd
Ste 1a
St Augustine, FL 32086-6485
Phone (904) 999-7873

Other practice location 1

150 Kent Rd
Ste 1a
St Augustine, FL 32086-6485
Phone (904) 999-7873

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181116000569 FL Practitioner - Chiropractic 5698797421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

150 Kent Rd
Suite 1a
St Augustine, FL 32086-6485
Phone (917) 673-6847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008694NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
DME DC Provider LLC Chiropractor PastSince Oct 5, 2018 Accepting new patients

Organizations & group practices 2

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": "1481155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1578007696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 KENT RD",
            "address_2": "STE 1A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866485",
            "telephone_number": "904-999-7873",
            "fax_number": "904-683-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 KENT RD STE 1A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866485",
            "telephone_number": "917-673-6847",
            "fax_number": "904-683-4871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 KENT RD",
            "address_2": "STE 1A",
            "address_purpose": "LOCATION",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866485",
            "country_code": "US",
            "telephone_number": "904-999-7873",
            "fax_number": "904-683-4871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASCUAL",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-08",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.