NPIMap

Organization Active NPI

Proactive Health of Mandarin LLC

  • Health Service Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1639542384
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
CH11696 Issued in FL
Legal business name
PROACTIVE HEALTH OF MANDARIN LLC
Practice address
12428 San Jose Blvd Ste 2
Jacksonville, FL 32223-8617
Phone
(904) 704-3683
Fax
(904) 288-8995
NPI assigned
Nov 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Authorized official

Name
Dr. April Deann Swanstrom, D.C.
Title
Chiropractic Physician
Phone
(904) 704-3683

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X CH11696 FL Primary

Addresses

Primary practice location

12428 San Jose Blvd Ste 2
Jacksonville, FL 32223-8617

Mailing address

12428 San Jose Blvd Ste 2
Jacksonville, FL 32223-8617
Phone (904) 704-3683

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1639542384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12428 SAN JOSE BLVD STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238617",
            "telephone_number": "904-704-3683",
            "fax_number": "904-288-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12428 SAN JOSE BLVD STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238617",
            "telephone_number": "904-704-3683",
            "fax_number": "904-288-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE HEALTH OF MANDARIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-03",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "SWANSTROM",
        "authorized_official_first_name": "APRIL",
        "authorized_official_middle_name": "DEANN",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "904-704-3683",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "CH11696",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 3, 2015; 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.