NPIMap

Organization Active NPI

Dr. Kelly J. Huber, Inc

Doing business as Chiropractic PLUS

  • Nutrition Chiropractor
  • Ponte Vedra Beach, FL
National Provider Identifier
1841430683
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
CH 7315 Issued in FL
Legal business name
DR. KELLY J. HUBER, INC
Doing business as
Chiropractic PLUS
Practice address
135 Professional Dr Ste 105
Ponte Vedra Beach, FL 32082-7228
Phone
(904) 280-1101
Fax
(904) 280-1102
NPI assigned
Mar 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Authorized official

Name
Dr. Kelly J Huber, D.C.NPI 1831214584
Title
Chiropractor
Phone
(904) 280-1101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CH 8850 FL
Nutrition ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NN1001X CH 7315 FL Primary

Addresses

Primary practice location

135 Professional Dr Ste 105
Ponte Vedra Beach, FL 32082-7228

Mailing address

135 Professional Dr Ste 105
Ponte Vedra Beach, FL 32082-7228
Phone (904) 280-1101

Other names 1

  • Chiropractic PLUS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120320000549 FL Part B Supplier - Clinic/Group Practice 6103086780 Receives reassigned benefits from 3 practitioners
Practice locations: Jacksonville, FL; Ponte Vedra Beach, FL

National Provider Directory

National Provider Directory

Locations

11512 Lake Mead Ave
Unit 203
Jacksonville, FL 32256
Phone (904) 565-1116

135 Professional Dr
Ste 105
Ponte Vedra Beach, FL 32082
Phone (904) 280-1101

135 Professional Dr
Ponte Vedra Beach, FL 32082
Phone (904) 280-1101

Practitioners & affiliated clinicians

Practitioners 4

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": "1236211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1841430683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 PROFESSIONAL DR STE 105",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320827228",
            "telephone_number": "904-280-1101",
            "fax_number": "904-280-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PROFESSIONAL DR STE 105",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320827228",
            "telephone_number": "904-280-1101",
            "fax_number": "904-280-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KELLY J. HUBER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-05",
        "last_updated": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "HUBER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "904-280-1101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 8850",
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "FL",
            "license": "CH 7315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chiropractic PLUS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.