Organization Active NPI

Tender Chiropractic Health Center PA

  • Chiropractor
  • Jacksonville Beach, FL
National Provider Identifier
1720064520
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7782 Issued in FL
Legal business name
TENDER CHIROPRACTIC HEALTH CENTER PA
Practice address
219 North 11TH Ave
Jacksonville Beach, FL 32250
Phone
(904) 247-0058
Fax
(904) 242-9779
NPI assigned
Dec 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Authorized official

Name
Dr. John G Tender, DCNPI 1285817320
Title
Chiropractor
Phone
(904) 247-0058

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: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH7782 FL Primary

Addresses

Primary practice location

219 North 11TH Ave
Jacksonville Beach, FL 32250

Mailing address

219 North 11TH Ave
Jacksonville Beach, FL 32250
Phone (904) 247-0058

Other identifiers 1

IdentifierTypeStateIssuer
280005500MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101101000316 FL Part B Supplier - Clinic/Group Practice 4183818479 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville Beach, FL

National Provider Directory

National Provider Directory

Locations

219 11th Ave N
Jax Bch, FL 32250
Phone (904) 247-0058

Practitioners & affiliated clinicians

Practitioners 1

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": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1720064520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 NORTH 11TH AVE",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "32250",
            "telephone_number": "904-247-0058",
            "fax_number": "904-242-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 NORTH 11TH AVE",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "32250",
            "telephone_number": "904-247-0058",
            "fax_number": "904-242-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENDER CHIROPRACTIC HEALTH CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "TENDER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "904-247-0058",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280005500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.