Organization Active NPI

Stevens Family Chiropractic P L

  • Chiropractor
  • Fort Myers, FL
National Provider Identifier
1639339559
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 7948 Issued in FL
Legal business name
STEVENS FAMILY CHIROPRACTIC P L
Practice address
14090 Metropolis Ave
Ste 101
Fort Myers, FL 33912-4450
Phone
(239) 489-4100
Fax
(239) 489-1314
NPI assigned
Jun 13, 2008
Last updated
Jun 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Dr. Linda Dorothy Stevens, D.C.NPI 1013935345
Title
Ceo
Phone
(239) 489-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH 7948 FL Primary

Addresses

Primary practice location

14090 Metropolis Ave
Ste 101
Fort Myers, FL 33912-4450

Mailing address

14090 Metropolis Ave
Ste 101
Fort Myers, FL 33912-4450
Phone (239) 489-4100

Other identifiers 2

IdentifierTypeStateIssuer
53890OtherFLBLUE CROSS BLUE SHIELD OF FLORIDA
8197780OtherFLCIGNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080710000517 FL Part B Supplier - Clinic/Group Practice 1658443403 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

14090 Metropolis Ave
Fort Myers, FL 33912

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1639339559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14090 METROPOLIS AVE",
            "address_2": "STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124450",
            "telephone_number": "239-489-4100",
            "fax_number": "239-489-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14090 METROPOLIS AVE",
            "address_2": "STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124450",
            "telephone_number": "239-489-4100",
            "fax_number": "239-489-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVENS FAMILY CHIROPRACTIC P L",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-13",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "DOROTHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "239-489-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 7948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF FLORIDA",
            "identifier": "53890",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8197780",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.