Active NPI
Michael D Struble, DC
- Chiropractor
- Palm Coast, FL
National Provider Identifier
1811092430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH8753
- Practice address
- 4883 Palm Coast Pkwy NW Unit 4
Palm Coast, FL 32137-3675 - Phone
- (386) 445-6565
- Fax
- (386) 445-4481
- NPI assigned
- Sep 14, 2006
- Last updated
- Apr 5, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH8753 | FL | Primary |
Addresses
Primary practice location
4883 Palm Coast Pkwy NW Unit 4
Palm Coast, FL 32137-3675
Mailing address
4883 Palm Coast Pkwy NW Unit 4
Palm Coast, FL 32137-3675
Phone (386) 445-6565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89713 | Other | FL | BCBS |
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
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333584000000",
"number": "1811092430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4883 PALM COAST PKWY NW UNIT 4",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321373675",
"telephone_number": "386-445-6565",
"fax_number": "386-445-4481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4883 PALM COAST PKWY NW UNIT 4",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321373675",
"telephone_number": "386-445-6565",
"fax_number": "386-445-4481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRUBLE",
"first_name": "MICHAEL",
"middle_name": "D",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2012-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH8753",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "89713",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Palm Coast, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.