Fortitude Family Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

FORTITUDE FAMILY CHIROPRACTIC LLC

Practice address

10915 Baymeadows Rd Ste 104
Jacksonville, FL 32256-9131

Phone

(904) 312-7575

NPI assigned

Aug 4, 2022

Organization subpart

No

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

Authorized official

Name

Matthew Rauco, DCNPI 1417684994

Title

Owner/Provider

Phone

(904) 316-3404

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

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.

• Matthew Rauco, DC

  • Chiropractor
  • Jacksonville, FL
  • NPI 1417684994
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1629705132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4423 HUNTINGTON FOREST BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322577570",
            "telephone_number": "904-316-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10915 BAYMEADOWS RD STE 104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569131",
            "telephone_number": "904-312-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTITUDE FAMILY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "RAUCO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "904-316-3404",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Anthony Fort, D.C
• Adria Pratt Forte, LMHC
• Antonio Forte, MD
• Debra Ann Forte, CRNA
• Gianna Maria Forte
• Grady Ausbur Fortner, M.D.
• Szilvia Fortner, APRN
• William Scott Fortney, PT
• Britta Fortson, M.A. CCC-SLP
• Clarina Fortune

• Chiropractor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Chiropractor in Florida

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