NPIMap

Organization Active NPI

Jupiter Healthcare

  • Chiropractor
  • Jupiter, FL
National Provider Identifier
1750447397
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
JUPITER HEALTHCARE
Practice address
125 W Indiantown Rd
Suite 105
Jupiter, FL 33458-3539
Phone
(561) 741-7575
Fax
(561) 741-7155
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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

Authorized official

Name
Dr. Joseph Todd Boudreau, D.C.NPI 1083770671
Title
Managing Partner
Phone
(561) 741-7575

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

125 W Indiantown Rd
Suite 105
Jupiter, FL 33458-3539

Mailing address

125 W Indiantown Rd
Suite 105
Jupiter, FL 33458-3539
Phone (561) 741-7575

Other identifiers 1

IdentifierTypeStateIssuer
74811OtherFLBCBS GROUP #

National Provider Directory

National Provider Directory

Locations

125 W Indiantown Rd
Ste 105
Jupiter, FL 33458
Phone (561) 741-7575

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1750447397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 W INDIANTOWN RD",
            "address_2": "SUITE 105",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334583539",
            "telephone_number": "561-741-7575",
            "fax_number": "561-741-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W INDIANTOWN RD",
            "address_2": "SUITE 105",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334583539",
            "telephone_number": "561-741-7575",
            "fax_number": "561-741-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUPITER HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "BOUDREAU",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "561-741-7575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "74811",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; 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.