Organization Active NPI

Michael T. Coyle, DC, PA

  • Chiropractor
  • Lakeland, FL
National Provider Identifier
1841590791
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7409 Issued in FL
Legal business name
MICHAEL T. COYLE, DC, PA
Practice address
1131 Bartow Rd
Lakeland, FL 33801-5949
Phone
(863) 687-4540
Fax
(863) 683-0830
NPI assigned
Oct 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Authorized official

Name
Dr. Michael T. Coyle, D.C.NPI 1851409833
Title
Owner
Phone
(863) 687-4540

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH7409 FL Primary

Addresses

Primary practice location

1131 Bartow Rd
Lakeland, FL 33801-5949

Mailing address

1131 Bartow Rd
Lakeland, FL 33801-5949
Phone (863) 687-4540

Other identifiers 1

IdentifierTypeStateIssuer
381181600MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101101001265 FL Part B Supplier - Clinic/Group Practice 4880888031 Receives reassigned benefits from 1 practitioner
Practice locations: Lakeland, FL

National Provider Directory

National Provider Directory

Locations

1131 US Highway 98
Lakeland, FL 33801
Phone (863) 687-4540

Practitioners & affiliated clinicians

Practitioners 2

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": "1288051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1841590791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 BARTOW RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015949",
            "telephone_number": "863-687-4540",
            "fax_number": "863-683-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 BARTOW RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015949",
            "telephone_number": "863-687-4540",
            "fax_number": "863-683-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL T. COYLE, DC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-26",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "COYLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-687-4540",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381181600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; 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.