Darrel Thomas Mathis, D.C.,F.A.C.O.

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

CH5141 Issued in FL

Practice address

279 SW Main Blvd
Lake City, FL 32025-7050

Phone

(386) 752-4313

Fax

(386) 752-8356

NPI assigned

Jul 12, 2005

Last updated

Apr 4, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Columbia County Chiropractic Center, LLC

  dba Darrel Thomas Mathis

  • Orthopedic Chiropractor
  • Lake City, FL
  • NPI 1467652578
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1679571822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320257050",
            "telephone_number": "386-752-4313",
            "fax_number": "386-752-8356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320257050",
            "telephone_number": "386-752-4313",
            "fax_number": "386-752-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "DARREL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.,F.A.C.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "FL",
            "license": "CH5141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350023404",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "050782200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Martino, APRN
• Taylor Nicole Martino, PHARMD
• Emily E Masten
• Ceili Masterson, DMD
• David Mate, MSW, LCSW
• David Ellery Mathis, PHARMD
• Carroll Clayton Matthews
• Jarvis Matthews
• Marilyn Matthews, LCSW
• Scott Michael Mattimore, RN

• Orthopedic Chiropractor in Lake City, FL
• Providers in Lake City, FL by specialty
• Orthopedic Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; 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.