Individual provider Active NPI

Jonathan D'Cruz, DC

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1649736810
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12709 Issued in FL
Practice address
9250 Cypress Green Dr
Jacksonville, FL 32256-1885
Phone
(904) 269-2437
NPI assigned
Feb 13, 2019
Last updated
Feb 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12709 FL Primary

Addresses

Primary practice location

9250 Cypress Green Dr
Jacksonville, FL 32256-1885

Mailing address

1218 Park Ave
Orange Park, FL 32073-4152
Phone (904) 269-2437

Other identifiers 1

IdentifierTypeStateIssuer
CH12709OtherFLCHIROPRACTIC

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CH12709FLMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1649736810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 PARK AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734152",
            "telephone_number": "904-269-2437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 CYPRESS GREEN DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322561885",
            "telephone_number": "904-269-2437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'CRUZ",
        "first_name": "JONATHAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-13",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC",
            "identifier": "CH12709",
            "state": "FL"
        }
    ],
    "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 Feb 13, 2019; 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.