Ethan Surprenant

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

15026 Issued in FL

Practice address

7601 Dr Martin Luther King Jr St N Ste E
St Petersburg, FL 33702-5200

Phone

(727) 677-0001

NPI assigned

May 16, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Cerebral Chiropractic Center LLC

  • Chiropractor
  • St. Petersburg, FL
  • NPI 1932961588
  NPD

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1669221180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 DR MARTIN LUTHER KING JR ST N STE E",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337025200",
            "telephone_number": "727-677-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 DR MARTIN LUTHER KING JR ST N STE E",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337025200",
            "telephone_number": "727-677-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURPRENANT",
        "first_name": "ETHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "15026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunspire Health Florida, LLC
• Superior Medical Solutions
• Superior Staffing
• Support360 Inc.
• Supportive Helping Hands
• Sustainable Family Services LLC
• Sustainable Family Services LLC
• Sustaining Hope and Wellness, LLC
• Gabriela Ycaza Sutherland
• Rebecca Sutphen, MD

• Chiropractor in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.