Individual provider Active NPI

Eric Chance, D.C.

  • Chiropractor
  • Port Saint Lucie, FL
National Provider Identifier
1790112597
Registry record updated Aug 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 10992 Issued in FL
Practice address
10050 SW Innovation Way
Suite 201
Port Saint Lucie, FL 34987-2117
Phone
(772) 879-8700
Fax
(772) 879-8710
NPI assigned
Oct 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2014

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 10992 FL Primary

Addresses

Primary practice location

10050 SW Innovation Way
Suite 201
Port Saint Lucie, FL 34987-2117

Mailing address

10050 SW Innovation Way
Suite 201
Port Saint Lucie, FL 34987-2117
Phone (772) 879-8700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150128000950 FL Practitioner - Chiropractic 0840514568 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
Group practices

Practice addresses (Care Compare)

324 Cross St
Punta Gorda, FL 33950-4828
Phone (941) 205-2180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 10992FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spinal Health and Rehab of Punta Gorda CurrentSince Feb 9, 2015 Accepting new patients

Locations

2905 Tamiami Trl
Punta Gorda, FL 33950
Phone (941) 205-2180

324 Cross St
Punta Gorda, FL 33950
Phone (941) 205-2180

Organizations & group practices 1

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": "1381449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407456000000",
    "number": "1790112597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10050 SW INNOVATION WAY",
            "address_2": "SUITE 201",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872117",
            "telephone_number": "772-879-8700",
            "fax_number": "772-879-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10050 SW INNOVATION WAY",
            "address_2": "SUITE 201",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872117",
            "telephone_number": "772-879-8700",
            "fax_number": "772-879-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANCE",
        "first_name": "ERIC",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-11",
        "last_updated": "2014-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 10992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; 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.