Organization Active NPI

Thorassic Park, Inc

  • Orthopedic Chiropractor
  • Bradenton, FL
National Provider Identifier
1780952937
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
CH2745 Issued in FL
Legal business name
THORASSIC PARK, INC
Practice address
1603 60TH Ave W
Bradenton, FL 34207-4658
Phone
(941) 758-1402
NPI assigned
Dec 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Authorized official

Name
Mr. Leo Rangel, D.C.
Title
Owner-President
Phone
(941) 758-1402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NX0800X CH2745 FL Primary

Addresses

Primary practice location

1603 60TH Ave W
Bradenton, FL 34207-4658

Mailing address

1603 60TH Ave W
Bradenton, FL 34207-4658
Phone (941) 758-1402

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040602000819 FL Part B Supplier - Clinic/Group Practice 2961484167 Receives reassigned benefits from 2 practitioners
Practice locations: Bradenton, FL

National Provider Directory

National Provider Directory
Tax ID family
Thorassic Park2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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": "1322784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322784000000",
    "number": "1780952937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 60TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342074658",
            "telephone_number": "941-758-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 60TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342074658",
            "telephone_number": "941-758-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THORASSIC PARK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-02",
        "last_updated": "2011-12-02",
        "status": "A",
        "authorized_official_last_name": "RANGEL",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "OWNER-PRESIDENT",
        "authorized_official_telephone_number": "941-758-1402",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": "FL",
            "license": "CH2745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; 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.