Revive Chiropractic & Wellness, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH9924 Issued in FL

Legal business name

REVIVE CHIROPRACTIC & WELLNESS, LLC

Practice address

3546 Saint Johns Bluff Rd S Unit 204
Jacksonville, FL 32224-2716

Phone

(904) 996-2243

NPI assigned

Apr 12, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Zachary W Stalnaker, D.C.

Title

MGRM/Owner

Phone

(904) 996-2243

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757462400000",
    "number": "1790042943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3546 SAINT JOHNS BLUFF RD S UNIT 204",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242716",
            "telephone_number": "904-996-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3546 SAINT JOHNS BLUFF RD S UNIT 204",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242716",
            "telephone_number": "904-996-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE CHIROPRACTIC & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-12",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A",
        "authorized_official_last_name": "STALNAKER",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MGRM/OWNER",
        "authorized_official_telephone_number": "904-996-2243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9924",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH3311",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Jacksonville, FL
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• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; 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.