Organization Active NPI

Medical & Chiropractic Clinic, Inc

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1801196258
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH004212 Issued in FL
Legal business name
MEDICAL & CHIROPRACTIC CLINIC, INC
Practice address
4602 N Nebraska Ave
Tampa, FL 33603-4014
Phone
(813) 237-3791
Fax
(813) 237-3792
NPI assigned
Nov 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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

Authorized official

Name
Dr. Gregory L. Williams, D.C.
Title
Owner
Phone
(813) 237-3791

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH004212 FL Primary

Addresses

Primary practice location

4602 N Nebraska Ave
Tampa, FL 33603-4014

Mailing address

4602 N Nebraska Ave
Tampa, FL 33603-4014
Phone (813) 237-3791

Other identifiers 1

IdentifierTypeStateIssuer
045896100MedicaidFL

National Provider Directory

National Provider Directory

Locations

4602 N Nebraska Ave
Tampa, FL 33603
Phone (813) 237-3791

Practitioners & affiliated clinicians

Practitioners 1

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": "1288569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288569600000",
    "number": "1801196258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 N NEBRASKA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336034014",
            "telephone_number": "813-237-3791",
            "fax_number": "813-237-3792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 N NEBRASKA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336034014",
            "telephone_number": "813-237-3791",
            "fax_number": "813-237-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL & CHIROPRACTIC CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-01",
        "last_updated": "2010-11-01",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-237-3791",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH004212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045896100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; 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.