Individual provider Active NPI

Stephanie Durocher, DC

  • Chiropractor
  • St Petersburg, FL
National Provider Identifier
1720644131
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12810 Issued in FL
Practice address
3200 4TH St N
St Petersburg, FL 33704-2127
Phone
(727) 823-3151
NPI assigned
May 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12810 FL
Chiropractor 111N00000X CH12810 FL Primary

Addresses

Primary practice location

3200 4TH St N
St Petersburg, FL 33704-2127

Mailing address

5828 51St St S
Saint Petersburg, FL 33715-1612
Phone (434) 610-3711

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

State licenses

LicenseStateTypeSpecialty
12810FLMDChiropractor

Interoperability endpoints

  • Direct secure messaging: stephanie.durocher.1@11209.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1720644131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5828 51ST ST S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337151612",
            "telephone_number": "434-610-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337042127",
            "telephone_number": "727-823-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUROCHER",
        "first_name": "STEPHANIE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "12810",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.