Joleene Anderson, D.C.

Individual provider Active NPI Nutrition Chiropractor · Winter Haven, FL

NPI 1598063505 · NPPES record last updated Sep 12, 2013

Key facts

NPI
1598063505
Entity type
Individual (NPI type 1)
Primary specialty
Nutrition Chiropractor 111NN1001X
License
CH8636 (FL)
Practice address
20 3Rd St SW
Suite 200
Winter Haven, FL 33880
Phone
(863) 325-4374
Fax
(888) 488-2874
NPI assigned
Mar 1, 2011
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4555 N Lincoln Ave
Chicago, IL 60625-2102

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260327001660 IL Practitioner - Chiropractic 5395220370 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
CH8636FLMDNutrition Chiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X CH8636 FL Yes

Addresses

Primary practice location

20 3Rd St SW
Suite 200
Winter Haven, FL 33880

Mailing address

20 3Rd St SW
Suite 200
Winter Haven, FL 33880
Phone (863) 325-4374

Other providers in Winter Haven, FL

All providers in Winter Haven, FL · Nutrition Chiropractor in Florida

Sources for this page

Verify at the official NPI Registry.