Individual provider Active NPI

Eric Edgerton, D.C.

  • Chiropractor
  • Clearwater, FL
National Provider Identifier
1780966887
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 10333 Issued in FL
Practice address
29901 US Highway 19 N
Clearwater, FL 33761-1041
Phone
(727) 286-6203
Fax
(727) 286-6204
NPI assigned
Sep 14, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 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 10333 FL Primary

Addresses

Primary practice location

29901 US Highway 19 N
Clearwater, FL 33761-1041

Mailing address

29901 US Highway 19 N
Clearwater, FL 33761-1041
Phone (727) 286-6203

Other identifiers 2

IdentifierTypeStateIssuer
12323896OtherFLCAQH
220HDOtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 10333FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Auto Injury Treatment Clinic LLC Chiropractor Current Accepting new patients
Nassberg Diabetes Associates Inc Current Accepting new patients

Locations

417 Apollo Beach Blvd
Apollo Beach, FL 33572
Phone (813) 733-5883

Organizations & group practices 2

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": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1780966887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29901 US HIGHWAY 19 N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337611041",
            "telephone_number": "727-286-6203",
            "fax_number": "727-286-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29901 US HIGHWAY 19 N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337611041",
            "telephone_number": "727-286-6203",
            "fax_number": "727-286-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGERTON",
        "first_name": "ERIC",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-14",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 10333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12323896",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "220HD",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.