Organization Active NPI

Somersall Chiropractic LLC

  • Clinic/Center
  • Palm Bay, FL
National Provider Identifier
1760624563
Registry record updated Mar 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
CH9654 Issued in FL
Legal business name
SOMERSALL CHIROPRACTIC LLC
Practice address
4670 Babcock St NE
Suite 5
Palm Bay, FL 32905-2841
Phone
(321) 821-7866
NPI assigned
Mar 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2009

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

Authorized official

Name
Mia Somersall HoseyNPI 1184869067
Title
Member
Phone
(321) 506-5462

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X CH9654 FL Primary

Addresses

Primary practice location

4670 Babcock St NE
Suite 5
Palm Bay, FL 32905-2841

Mailing address

4670 Babcock St NE
Suite 5
Palm Bay, FL 32905-2841
Phone (321) 821-7866

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091111000109 FL Part B Supplier - Clinic/Group Practice 5597803627 Receives reassigned benefits from 1 practitioner
Practice locations: Melbourne, FL

National Provider Directory

National Provider Directory

Locations

11 Edgewood Dr
Melbourne, FL 32901
Phone (321) 821-7866

4670 Babcock St NE
Ste 5
Palm Bay, FL 32905
Phone (321) 288-0692

Practitioners & affiliated clinicians

Practitioners 2

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": "1238025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238025600000",
    "number": "1760624563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4670 BABCOCK ST NE",
            "address_2": "SUITE 5",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052841",
            "telephone_number": "321-821-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4670 BABCOCK ST NE",
            "address_2": "SUITE 5",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052841",
            "telephone_number": "321-821-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERSALL CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-26",
        "last_updated": "2009-03-26",
        "status": "A",
        "authorized_official_last_name": "HOSEY",
        "authorized_official_first_name": "MIA",
        "authorized_official_middle_name": "SOMERSALL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "321-506-5462"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "CH9654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.