Chiro & Laser St. Augustine, PLLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

CHIRO & LASER ST. AUGUSTINE, PLLC

Practice address

1092 S Ponce de Leon Blvd Ste K
St Augustine, FL 32084-6018

Phone

(940) 460-2923

NPI assigned

Apr 5, 2022

Last updated

Jun 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jason PalmerNPI 1740418771

Title

Owner

Phone

(909) 800-5839

Specialties & licenses 1

Addresses

Other names 1

• Chiro & Laser St. Augustine Former legal business name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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.

• Jason Anthony Palmer, D.C.

  • Chiropractor
  • Redlands, CA
  • NPI 1740418771

  FL

  Medicare reassignment NPD Authorized official
• Richard R Bloom, DC

  • Chiropractor
  • Jacksonville, FL
  • NPI 1548298250
  NPD
• Gary Charles Trupo, D.C.

  • Chiropractor
  • St Augustine, FL
  • NPI 1942422126
  NPD

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1578204459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1092 S PONCE DE LEON BLVD STE K",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1092 S PONCE DE LEON BLVD STE K",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846018",
            "telephone_number": "940-460-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO & LASER ST. AUGUSTINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-800-5839",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chiro & Laser St. Augustine",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Chiro & Laser St. Augustine",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Children's Home Society of Florida
• Children's Home Society of Florida
• Catherine Penn Childress, DPT
• Chinasa LLC (Abundant Homemakers)
• Chiro & Laser Pain Relief Center of St Augustine LLC
• Christy M Chong, ARNP
• Kok L. Chong, MD
• Kye Im Chong, MD
• Rezwana Chowdhury
• Susan Therese Christ, MD

• Health Service Clinic/Center in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.