Organization Active NPI

Sun Life Chiropractic and Injury Center LLC

  • Chiropractor
  • Davenport, FL
National Provider Identifier
1720400500
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 10980 Issued in FL
Legal business name
SUN LIFE CHIROPRACTIC AND INJURY CENTER LLC
Practice address
39857 Highway 27
Davenport, FL 33837-7802
Phone
(561) 305-9836
NPI assigned
Jan 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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

Authorized official

Name
Dr. Alexis Samaniego, D.C.NPI 1477987980
Title
Owner/ Chiropractor
Phone
(561) 305-9836

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 CH 10980 FL Primary

Addresses

Primary practice location

39857 Highway 27
Davenport, FL 33837-7802

Mailing address

39857 Highway 27
Davenport, FL 33837-7802
Phone (561) 305-9836

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140821000453 FL Part B Supplier - Clinic/Group Practice 1254559941 Receives reassigned benefits from 1 practitioner
Practice locations: Davenport, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389571200000",
    "number": "1720400500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39857 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338377802",
            "telephone_number": "561-305-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39857 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338377802",
            "telephone_number": "561-305-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN LIFE CHIROPRACTIC AND INJURY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-13",
        "last_updated": "2014-01-13",
        "status": "A",
        "authorized_official_last_name": "SAMANIEGO",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_title_or_position": "OWNER/ CHIROPRACTOR",
        "authorized_official_telephone_number": "561-305-9836",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 10980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.