Individual provider Active NPI

Benjamin Dieffenbacher

  • Chiropractor
  • Coral Gables, FL
National Provider Identifier
1689030249
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH11657 Issued in FL
Practice address
430 S Dixie Hwy Ste 211
Coral Gables, FL 33146-2200
Phone
(786) 502-2173
Fax
(786) 221-3628
NPI assigned
Jan 12, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH11657 FL Primary

Addresses

Primary practice location

430 S Dixie Hwy Ste 211
Coral Gables, FL 33146-2200

Mailing address

13865 S Dixie Hwy
Suite 307
Miami, FL 33176-7221
Phone (305) 252-9090

Other practice location 1

13865 S Dixie Hwy
Suite 307
Miami, FL 33176-7221
Phone (305) 252-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CH11657FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Oriental Medical Doctor, Inc Past Accepting new patients
Mobile Chiropractic Chiropractor Past Accepting new patients

Organizations & group practices 2

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": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1689030249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13865 S DIXIE HWY",
            "address_2": "SUITE 307",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331767221",
            "telephone_number": "305-252-9090",
            "fax_number": "305-252-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 S DIXIE HWY STE 211",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462200",
            "telephone_number": "786-502-2173",
            "fax_number": "786-221-3628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13865 S Dixie Hwy",
            "address_2": "Suite 307",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331767221",
            "country_code": "US",
            "telephone_number": "305-252-9090",
            "fax_number": "305-252-9058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIEFFENBACHER",
        "first_name": "BENJAMIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-12",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.