Individual provider Active NPI

Matthew David Lowry, D.C.

  • Chiropractor
  • Port Orange, FL
National Provider Identifier
1770917882
Registry record updated Aug 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 10971 Issued in FL
Practice address
5111 S Ridgewood Ave
Suite 103
Port Orange, FL 32127-5169
Phone
(386) 310-8766
Fax
(386) 310-8770
NPI assigned
Aug 26, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 10971 FL Primary

Addresses

Primary practice location

5111 S Ridgewood Ave
Suite 103
Port Orange, FL 32127-5169

Mailing address

3037 Oak Hammock Dr
Port Orange, FL 32129-6203
Phone (620) 222-8616

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131231000759 FL Practitioner - Chiropractic 6608004395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

601 E Call St
Starke, FL 32091-3405
Phone (904) 964-8018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chirocure Health Center LLC Chiropractor CurrentSince Apr 11, 2016 Accepting new patients
Bibco Inc Chiropractor CurrentSince Jan 10, 2019 Accepting new patients

Locations

8833 Perimeter Park Blvd
Ste 102
Jacksonville, FL 32216
Phone (904) 497-0823

601 E Call St
Starke, FL 32091
Phone (904) 964-8018

Organizations & group practices 3

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": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1770917882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3037 OAK HAMMOCK DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296203",
            "telephone_number": "620-222-8616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 S RIDGEWOOD AVE",
            "address_2": "SUITE 103",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321275169",
            "telephone_number": "386-310-8766",
            "fax_number": "386-310-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWRY",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-26",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 10971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; 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.