NPIMap

Organization Active NPI

Mark Pierce Chiropractic Clinic

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1598899080
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6451 Issued in FL
Legal business name
MARK PIERCE CHIROPRACTIC CLINIC
Practice address
12620 Beach Blvd Ste 6
Jacksonville, FL 32246-7130
Phone
(904) 645-0777
Fax
(904) 645-3483
NPI assigned
Mar 15, 2007
Last updated
Oct 31, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Authorized official

Name
Mrs. Elaine C Pierce
Title
Office Manager
Phone
(904) 645-0777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH6451 FL Primary

Addresses

Primary practice location

12620 Beach Blvd Ste 6
Jacksonville, FL 32246-7130

Mailing address

12620 Beach Blvd Ste 6
Jacksonville, FL 32246-7130
Phone (904) 645-0777

Other identifiers 1

IdentifierTypeStateIssuer
55291OtherFLBLUE CROSS PROVIDER NUMBE

National Provider Directory

National Provider Directory

Locations

12620 Beach Blvd
Ste 6
Jacksonville, FL 32246
Phone (904) 645-0777

Practitioners & affiliated clinicians

Practitioners 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1598899080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12620 BEACH BLVD STE 6",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467130",
            "telephone_number": "904-645-0777",
            "fax_number": "904-645-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12620 BEACH BLVD STE 6",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467130",
            "telephone_number": "904-645-0777",
            "fax_number": "904-645-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK PIERCE CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-645-0777",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "55291",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.