Individual provider Active NPI

Tara Renee Cheuvront, D.C.

  • Chiropractor
  • Port Orange, FL
National Provider Identifier
1659673267
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10189 Issued in FL
Practice address
4705 Clyde Morris Blvd
Suite 108
Port Orange, FL 32129-4103
Phone
(386) 763-2718
Fax
(386) 763-2719
NPI assigned
Dec 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC01336 PA
Chiropractor 111N00000X CH10189 FL Primary

Addresses

Primary practice location

4705 Clyde Morris Blvd
Suite 108
Port Orange, FL 32129-4103

Mailing address

4705 Clyde Morris Blvd
Suite 108
Port Orange, FL 32129-4103
Phone (386) 763-2718

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130619000145 FL Practitioner - Chiropractic 4688813843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmer College FoundationGroup PAC ID 1557266863, 44 clinicians

Practice addresses (Care Compare)

4705 Clyde Morris Blvd
Port Orange, FL 32129-4103
Phone (386) 763-2718

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC01336PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Palmer College Foundation Chiropractor CurrentSince Jul 5, 2016 Accepting new patients
Palmer College Foundation Chiropractor CurrentSince Jul 5, 2016 Accepting new patients
North Orlando Spine Center, LLC Chiropractor CurrentSince Dec 17, 2009 Accepting new patients

Locations

311 N Clyde Morris Blvd
Ste 310
Daytona Beach, FL 32114
Phone (386) 257-6644

140 Crown Oak Centre Dr
Longwood, FL 32750
Phone (407) 331-9913

2170 W State Road 434
Ste 252
Longwood, FL 32779
Phone (407) 331-9913

4705 Clyde Morris Blvd
Pt Orange, FL 32129
Phone (386) 763-2712

1000 Brady St
Davenport, IA 52803
Phone (563) 884-5800

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1659673267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 CLYDE MORRIS BLVD",
            "address_2": "SUITE 108",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294103",
            "telephone_number": "386-763-2718",
            "fax_number": "386-763-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 CLYDE MORRIS BLVD",
            "address_2": "SUITE 108",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294103",
            "telephone_number": "386-763-2718",
            "fax_number": "386-763-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEUVRONT",
        "first_name": "TARA",
        "middle_name": "RENEE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-02",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC01336",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.