Individual provider Active NPI

Theresa A Carissimi, D.C.

  • Chiropractor
  • Hollywood, FL
National Provider Identifier
1811038664
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7432 Issued in FL
Practice address
9710 Stirling Rd
#112
Hollywood, FL 33024-8018
Phone
(954) 392-7700
Fax
(954) 392-7711
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7432 FL Primary

Addresses

Primary practice location

9710 Stirling Rd
#112
Hollywood, FL 33024-8018

Mailing address

18690 SW 7TH St
Pembroke Pines, FL 33029-6004
Phone (954) 392-7700

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
CH7432FLMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811038664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18690 SW 7TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330296004",
            "telephone_number": "954-392-7700",
            "fax_number": "954-392-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9710 STIRLING RD",
            "address_2": "#112",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330248018",
            "telephone_number": "954-392-7700",
            "fax_number": "954-392-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARISSIMI",
        "first_name": "THERESA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.