Organization Active NPI

Oviedo Chiropractic LLC

  • Chiropractor
  • Oviedo, FL
National Provider Identifier
1700286697
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
OVIEDO CHIROPRACTIC LLC
Practice address
2871 Clayton Crossing Way
Suite 1073
Oviedo, FL 32765-3426
Phone
(407) 542-1614
Fax
(407) 542-1615
NPI assigned
Aug 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Authorized official

Name
Justin CoughNPI 1144631821
Title
Director
Phone
(407) 542-1614

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2871 Clayton Crossing Way
Suite 1073
Oviedo, FL 32765-3426

Mailing address

2871 Clayton Crossing Way
Suite 1073
Oviedo, FL 32765-3426
Phone (407) 542-1614

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141023001283 FL Part B Supplier - Clinic/Group Practice 6002037678 Receives reassigned benefits from 3 practitioners
Practice locations: Oviedo, FL

National Provider Directory

National Provider Directory

Locations

2871 Clayton Crossing Way
Ste 1073
Oviedo, FL 32765
Phone (407) 542-1614

Interoperability endpoints

  • Direct secure messaging: jcough@oc0021.direct.chirotouch.md

Practitioners & affiliated clinicians

Practitioners 3

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": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1700286697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2871 CLAYTON CROSSING WAY",
            "address_2": "SUITE 1073",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327653426",
            "telephone_number": "407-542-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2871 CLAYTON CROSSING WAY",
            "address_2": "SUITE 1073",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327653426",
            "telephone_number": "407-542-1614",
            "fax_number": "407-542-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVIEDO CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "COUGH",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "407-542-1614"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; 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.