Active NPI
Randy L Chaulk, D.C.
- Chiropractor
- Deltona, FL
National Provider Identifier
1821274127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH0004569
- Practice address
- 1240 E Normandy Blvd
Deltona, FL 32725-8484 - Phone
- (386) 574-1464
- Fax
- (386) 574-4895
- NPI assigned
- Jan 16, 2008
- 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 | CH0004569 | FL | Primary |
Addresses
Primary practice location
1240 E Normandy Blvd
Deltona, FL 32725-8484
Mailing address
1115 Oak Springs PL
Lake Mary, FL 32746-4727
Phone (386) 846-4588
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 70466 | Other | FL | BCBS FL PROVIDER ID |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CH0004569 | FL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deltona Chiropractic & Advanced Pain Manangement Center LLC | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- Deltona, FL
- NPI 1881869543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287446400000",
"number": "1821274127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 OAK SPRINGS PL",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327464727",
"telephone_number": "386-846-4588",
"fax_number": "407-302-8628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1240 E NORMANDY BLVD",
"city": "DELTONA",
"state": "FL",
"postal_code": "327258484",
"telephone_number": "386-574-1464",
"fax_number": "386-574-4895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAULK",
"first_name": "RANDY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-16",
"last_updated": "2010-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH0004569",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FL PROVIDER ID",
"identifier": "70466",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Deltona, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.