Organization Active NPI

Terry Chiropractic, Inc.

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1760663231
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0004235 Issued in FL
Legal business name
TERRY CHIROPRACTIC, INC.
Practice address
9905 Old Saint Augustine Rd Ste 504
Jacksonville, FL 32257-8856
Phone
(904) 886-3118
Fax
(904) 886-3119
NPI assigned
Nov 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Authorized official

Name
Mrs. Melinda H Terry
Title
Office Manager
Phone
(904) 886-3118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH0004235 FL Primary

Addresses

Primary practice location

9905 Old Saint Augustine Rd Ste 504
Jacksonville, FL 32257-8856

Mailing address

9905 Old Saint Augustine Rd Ste 504
Jacksonville, FL 32257-8856
Phone (904) 886-3118

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041221000639 FL Part B Supplier - Clinic/Group Practice 4789642802 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

9905 Old St Augustine Rd
Ste 504
Jacksonville, FL 32257
Phone (904) 731-1663

Practitioners & affiliated clinicians

Practitioners 1

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": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352764800000",
    "number": "1760663231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9905 OLD SAINT AUGUSTINE RD STE 504",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578856",
            "telephone_number": "904-886-3118",
            "fax_number": "904-886-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9905 OLD SAINT AUGUSTINE RD STE 504",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578856",
            "telephone_number": "904-886-3118",
            "fax_number": "904-886-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRY CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2012-11-13",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-886-3118",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0004235",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 13, 2012; 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.