Active NPI
Craig Scott Mencl, D.C.
- Chiropractor
- Port Orange, FL
National Provider Identifier
1720104169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH10154
- Practice address
- 4705 S Clyde Morris Blvd
Port Orange, FL 32129-4103 - Phone
- (386) 763-2622
- NPI assigned
- Mar 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH10154 | FL | Primary |
Addresses
Primary practice location
4705 S Clyde Morris Blvd
Port Orange, FL 32129-4103
Mailing address
4705 S Clyde Morris Blvd
Port Orange, FL 32129-4103
Phone (386) 763-2622
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377216000000",
"number": "1720104169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4705 S CLYDE MORRIS BLVD",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321294103",
"telephone_number": "386-763-2622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4705 S CLYDE MORRIS BLVD",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321294103",
"telephone_number": "386-763-2622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENCL",
"first_name": "CRAIG",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-21",
"last_updated": "2013-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH10154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.