Individual provider Active NPI

Shane H. Silver, CHIROPRACTOR

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1760601504
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7588 Issued in FL
Practice address
1050 Riverside Ave
Suite B
Jacksonville, FL 32204-4123
Phone
(904) 634-0805
Fax
(904) 634-0950
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7588 FL Primary

Addresses

Primary practice location

1050 Riverside Ave
Suite B
Jacksonville, FL 32204-4123

Mailing address

1050 Riverside Ave
Suite B
Jacksonville, FL 32204-4123
Phone (904) 634-0805

Other identifiers 1

IdentifierTypeStateIssuer
53943OtherFLBLUECROSS BLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090729000626 FL Practitioner - Chiropractic 1052464641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chanatrydc, LLCGroup PAC ID 5698912194, 10 clinicians

Practice addresses (Care Compare)

2711 University Blvd N
Jacksonville, FL 32211-3235
Phone (904) 743-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chanatrydc, LLC Chiropractor CurrentSince Apr 18, 2024 Accepting new patients

Locations

2711 University Blvd N
Jacksonville, FL 32211
Phone (904) 473-6700

1050 Riverside Ave
Ste B
Jacksonville, FL 32204
Phone (904) 304-5011

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1760601504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 RIVERSIDE AVE",
            "address_2": "SUITE B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044123",
            "telephone_number": "904-634-0805",
            "fax_number": "904-634-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 RIVERSIDE AVE",
            "address_2": "SUITE B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044123",
            "telephone_number": "904-634-0805",
            "fax_number": "904-634-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVER",
        "first_name": "SHANE",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "CHIROPRACTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "53943",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.