NPIMap

Organization Active NPI

Deltona Chiropractic & Advanced Pain Management Center, LLC

  • Chiropractor
  • Deltona, FL
National Provider Identifier
1659504553
Registry record updated Aug 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9501 Issued in FL
Legal business name
DELTONA CHIROPRACTIC & ADVANCED PAIN MANAGEMENT CENTER, LLC
Practice address
1240 E Normandy Blvd
Deltona, FL 32725-8484
Phone
(386) 574-1464
Fax
(386) 574-4895
NPI assigned
Aug 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2009

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

Authorized official

Name
Dr. Randy L Chaulk, DC
Title
Registered Agent
Phone
(386) 846-4588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH9501 FL Primary

Addresses

Primary practice location

1240 E Normandy Blvd
Deltona, FL 32725-8484

Mailing address

1240 E Normandy Blvd
Deltona, FL 32725-8484
Phone (386) 574-1464

Other names 1

  • Deltona Advanced Medical Wellness Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251244800000",
    "number": "1659504553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 E NORMANDY BLVD",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327258484",
            "telephone_number": "386-574-1464",
            "fax_number": "386-574-4895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 E NORMANDY BLVD",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327258484",
            "telephone_number": "386-574-1464",
            "fax_number": "386-574-4895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTONA CHIROPRACTIC & ADVANCED PAIN MANAGEMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-26",
        "last_updated": "2009-08-26",
        "status": "A",
        "authorized_official_last_name": "CHAULK",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "386-846-4588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deltona Advanced Medical Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deltona, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2009; 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.