NPIMap

Organization Active NPI

Patrick J. Opachich, D.C.P.a.

  • Orthopedic Chiropractor
  • Jacksonville, FL
National Provider Identifier
1699067041
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
Legal business name
PATRICK J. OPACHICH, D.C.P.A.
Practice address
1610 Blanding Blvd
Jacksonville, FL 32210-1804
Phone
(904) 387-4151
Fax
(904) 389-8864
NPI assigned
May 4, 2011
Organization subpart
Yes
Parent organization
PATRICK J. OPACHICH, D.C.P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Authorized official

Name
Dr. Patrick Johnny Opachich, D.C.NPI 1366453375
Title
President
Phone
(904) 387-4151

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NX0800X CH4041 FL
Orthopedic ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NX0800X Primary
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

1610 Blanding Blvd
Jacksonville, FL 32210-1804

Mailing address

1610 Blanding Blvd
Jacksonville, FL 32210-1804
Phone (904) 387-4151

Other identifiers 1

IdentifierTypeStateIssuer
381306100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110713000672 FL Part B Supplier - Clinic/Group Practice 2668640855 Receives reassigned benefits from 2 practitioners
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory
Part of
Patrick Opachich DC

Locations

1610 Blanding Blvd
Jacksonville, FL 32210
Phone (904) 387-4151

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1699067041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322101804",
            "telephone_number": "904-387-4151",
            "fax_number": "904-389-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322101804",
            "telephone_number": "904-387-4151",
            "fax_number": "904-389-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK J. OPACHICH, D.C.P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATRICK J. OPACHICH, D.C.P.A.",
        "enumeration_date": "2011-05-04",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "OPACHICH",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "JOHNNY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-387-4151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": "FL",
            "license": "CH4041",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381306100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.