Individual provider Active NPI

Jose Reinaldo Heredia, D.C.

  • Chiropractor
  • Orlando, FL
National Provider Identifier
1639233208
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 7044 Issued in FL
Practice address
6236 Kingspointe Pkwy
Ste 9
Orlando, FL 32819-6530
Phone
(407) 240-9500
Fax
(407) 240-9500
NPI assigned
Dec 20, 2006
Last updated
Jul 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 7044 FL Primary

Addresses

Primary practice location

6236 Kingspointe Pkwy
Ste 9
Orlando, FL 32819-6530

Mailing address

PO Box 2358
Windermere, FL 34786-2358
Phone (407) 240-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 7044FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Heredia Health Clinic Inc Past Accepting new patients
Mauricio Chiropractic Poinciana LLC Chiropractor PastSince Sep 3, 2009 Accepting new patients
Mauricio Chiropractic West LLC Chiropractor PastSince Oct 10, 2006 Accepting new patients
Meyer Medical and Chiropractic Past Accepting new patients
Mauricio Chiropractic East Inc Chiropractor PastSince Nov 20, 2004 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1639233208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2358",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347862358",
            "telephone_number": "407-240-9500",
            "fax_number": "407-240-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6236 KINGSPOINTE PKWY",
            "address_2": "STE 9",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328196530",
            "telephone_number": "407-240-9500",
            "fax_number": "407-240-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEREDIA",
        "first_name": "JOSE",
        "middle_name": "REINALDO",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 7044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.