Active NPI
Christopher Albin Antczak, D.C.
- Chiropractor
- Fernandina Beach, FL
National Provider Identifier
1730462466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH9749
- Practice address
- 1114 S 14TH St
Fernandina Beach, FL 32034-2920 - Phone
- (904) 718-0074
- Fax
- (904) 261-5671
- NPI assigned
- Sep 20, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | CH9749 | FL | Primary |
Addresses
Primary practice location
1114 S 14TH St
Fernandina Beach, FL 32034-2920
Mailing address
1114 S 14TH St
Fernandina Beach, FL 32034-2920
Phone (904) 718-0074
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH9749 | FL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316476800000",
"number": "1730462466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1114 S 14TH ST",
"city": "FERNANDINA BEACH",
"state": "FL",
"postal_code": "320342920",
"telephone_number": "904-718-0074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1114 S 14TH ST",
"city": "FERNANDINA BEACH",
"state": "FL",
"postal_code": "320342920",
"telephone_number": "904-718-0074",
"fax_number": "904-261-5671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTCZAK",
"first_name": "CHRISTOPHER",
"middle_name": "ALBIN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-20",
"last_updated": "2011-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH9749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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- Cassandra Astolis
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.