Shine Chiropractic PLLC
Organization Active NPI Chiropractor · Freeport, FL
NPI 1720852437 · NPPES record last updated Nov 13, 2023
Key facts
- NPI
- 1720852437
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- SHINE CHIROPRACTIC PLLC
- Practice address
- 1255 Old Jolly Bay Rd Unit B101
Freeport, FL 32439-4275 - Phone
- (850) 880-6046
- NPI assigned
- Nov 13, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. Braxton Turnage, DC
- Title
- Owner
- Phone
- (850) 880-6046
Practitioners 2
-
Braxton Turnage, DC
-
Lana Winjum, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231227000627 | FL | Part B Supplier - Clinic/Group Practice | 8628428067 |
Receives reassigned benefits from 2 practitioners Practice locations: Freeport, FL |
National Provider Directory
Locations
1255 Old Jolly Bay Rd
Unit B101
Freeport, FL 32439
Phone (508) 880-6046
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
1255 Old Jolly Bay Rd Unit B101
Freeport, FL 32439-4275
Mailing address
1255 Old Jolly Bay Rd Unit B101
Freeport, FL 32439-4275
Phone (850) 880-6046
Other providers in Freeport, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.