Organization Active NPI

Roach Family Chiropractic LLC

  • Nutrition Chiropractor
  • Altamonte Springs, FL
National Provider Identifier
1578704458
Registry record updated Dec 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
9409 Issued in FL
Legal business name
ROACH FAMILY CHIROPRACTIC LLC
Practice address
251 N Maitland Ave
Suite 116
Altamonte Springs, FL 32701-4914
Phone
(407) 647-2009
Fax
(407) 660-2009
NPI assigned
Mar 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2010

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

Authorized official

Name
Dr. Erik Roach, DC
Title
President / Ceo
Phone
(407) 647-2009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN1001X 9409 FL Primary

Addresses

Primary practice location

251 N Maitland Ave
Suite 116
Altamonte Springs, FL 32701-4914

Mailing address

251 N Maitland Ave
Suite 116
Altamonte Springs, FL 32701-4914
Phone (407) 647-2009

Other identifiers 1

IdentifierTypeStateIssuer
002190400MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291420800000",
    "number": "1578704458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 N MAITLAND AVE",
            "address_2": "SUITE 116",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014914",
            "telephone_number": "407-647-2009",
            "fax_number": "407-660-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 N MAITLAND AVE",
            "address_2": "SUITE 116",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014914",
            "telephone_number": "407-647-2009",
            "fax_number": "407-660-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROACH FAMILY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-23",
        "last_updated": "2010-12-04",
        "status": "A",
        "authorized_official_last_name": "ROACH",
        "authorized_official_first_name": "ERIK",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "407-647-2009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "FL",
            "license": "9409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002190400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2010; 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.