Palm Coast Chiropractic Center, Jta Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH8483 Issued in FL

Legal business name

PALM COAST CHIROPRACTIC CENTER, JTA INC

Practice address

4721 E Moody Blvd
Suite 101
Bunnell, FL 32110-7706

Phone

(386) 437-7111

Fax

(386) 437-7790

NPI assigned

Sep 23, 2006

Last updated

Jun 6, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer L Thornton, DCNPI 1750463154

Title

President

Phone

(386) 437-7111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer L Thornton, DC

  • Chiropractor
  • Bunnell, FL
  • NPI 1750463154
  Medicare reassignment NPD Authorized official
• Kenneth William Davis, DC

  • Chiropractor
  • Palm Coast, FL
  • NPI 1740301886
  NPD (past)
• Joy Christine Imbeault, LMT

  • Massage Therapist
  • Bunnell, FL
  • NPI 1437003852

  Multi-Specialty

  NPD (past)
• Ross Alan Fialkov, D.C.

  • Chiropractor
  • Mountainside, NJ
  • NPI 1285969030
  NPD (past)

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402012800000",
    "number": "1679673396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4721 E MOODY BLVD",
            "address_2": "SUITE 101",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321107706",
            "telephone_number": "386-437-7111",
            "fax_number": "386-437-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4721 E MOODY BLVD",
            "address_2": "SUITE 101",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321107706",
            "telephone_number": "386-437-7111",
            "fax_number": "386-437-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM COAST CHIROPRACTIC CENTER, JTA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-23",
        "last_updated": "2014-06-06",
        "status": "A",
        "authorized_official_last_name": "THORNTON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-437-7111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Lynn Nelson, DPT
• Elizabeth Ann Oldham, LMT, FS, RCA
• Steven William Oliver, D.C.
• Optimum Care Pharmacy
• Our Docs Care Bunnell LLC
• Deborah Anne Panchella, ARNP
• Stacey Jeanne Pappas, M.D.
• Pathfinder Advocacy Center
• Patrick Reed DC PA
• Paul Bond, LLC (Bespoke Health)

• Chiropractor in Bunnell, FL
• Providers in Bunnell, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.