Individual provider Active NPI

Samuel Robert Meyers, DC

  • Chiropractor
  • St Petersburg, FL
National Provider Identifier
1639176647
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9191 Issued in FL
Practice address
4800 4TH St N
St Petersburg, FL 33703-3817
Phone
(727) 528-1133
Fax
(727) 527-3750
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9191 FL Primary

Addresses

Primary practice location

4800 4TH St N
St Petersburg, FL 33703-3817

Mailing address

4800 4TH St N
St Petersburg, FL 33703-3817
Phone (727) 528-1133

Other identifiers 1

IdentifierTypeStateIssuer
382075100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060824000153 FL Practitioner - Chiropractic 3779497714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Injury and Rehab IncGroup PAC ID 0547316457, 2 clinicians

Practice addresses (Care Compare)

4800 4TH St N
Saint Petersburg, FL 33703-3817
Phone (727) 528-1133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH9191FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Injury Physical Therapy Inc CurrentSince Aug 1, 2015 Accepting new patients
Bay Injury & Rehab Inc Chiropractor CurrentSince Jul 1, 2009 Accepting new patients
Raveling Chiropractic Center PA Chiropractor PastSince Jan 2, 2001 Accepting new patients
Garapola and Associates Chiropractic PA Chiropractor PastSince Nov 13, 2022 Accepting new patients
Bothell Regenerative Medicine Past Accepting new patients
Kaufman Chiropractic Clinic Inc Chiropractor PastSince Feb 18, 2013 Accepting new patients

Locations

4800 4th St N
St Petersburg, FL 33703
Phone (727) 498-6488

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1639176647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337033817",
            "telephone_number": "727-528-1133",
            "fax_number": "727-527-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337033817",
            "telephone_number": "727-528-1133",
            "fax_number": "727-527-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "SAMUEL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382075100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.