Prokosch Chiropractic Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH 9133 Issued in FL

Legal business name

PROKOSCH CHIROPRACTIC INC

Practice address

1300 Marsh Landing Pkwy Ste 107
Jacksonville Beach, FL 32250-2407

Phone

(904) 395-1460

Fax

(904) 395-1465

NPI assigned

Feb 23, 2009

Organization subpart

No

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

Authorized official

Name

Dr. John Joseph Prokosch, DC

Title

President

Phone

(904) 395-1460

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1750521340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MARSH LANDING PKWY STE 107",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502407",
            "telephone_number": "904-395-1460",
            "fax_number": "904-395-1465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MARSH LANDING PKWY STE 107",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502407",
            "telephone_number": "904-395-1460",
            "fax_number": "904-395-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROKOSCH CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "PROKOSCH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-395-1460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 9133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Jacksonville Beach, FL
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• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; 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.