Individual provider Active NPI

Russell Gregeor Goff, DC

  • Chiropractor
  • Clearwater, FL
National Provider Identifier
1710507041
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13123 Issued in FL
Practice address
635 Court St Ste 200
Clearwater, FL 33756-5512
Phone
(307) 840-1734
NPI assigned
Apr 16, 2020
Last updated
Apr 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 13123 FL Primary

Addresses

Primary practice location

635 Court St Ste 200
Clearwater, FL 33756-5512

Mailing address

635 Court St Ste 200
Clearwater, FL 33756-5512
Phone (307) 840-1734

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
13123FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1710507041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 COURT ST STE 200",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337565512",
            "telephone_number": "307-840-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 COURT ST STE 200",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337565512",
            "telephone_number": "307-840-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFF",
        "first_name": "RUSSELL",
        "middle_name": "GREGEOR",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-16",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "13123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; 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.