Individual provider Active NPI

Jessica Alysse Santos Cogo, D.C.

  • Chiropractor
  • Palm Coast, FL
National Provider Identifier
1841732112
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 12011 Issued in FL
Practice address
9 Palm Harbor Village Way Ste D
Palm Coast, FL 32137
Phone
(138) 660-3800
NPI assigned
Nov 17, 2016
Last updated
May 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 12011 FL Primary

Addresses

Primary practice location

9 Palm Harbor Village Way Ste D
Palm Coast, FL 32137

Mailing address

22A Plateau LN
Palm Coast, FL 32164-7439
Phone (386) 986-8013

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170403000508 FL Practitioner - Chiropractic 9830474998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
On Point Chiropractic LLCGroup PAC ID 3274885652, 2 clinicians

Practice addresses (Care Compare)

1 Florida Park Dr S
Suite 106
Palm Coast, FL 32137-3801
Phone (386) 603-8001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 12011FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
On Point Chiropractic LLC Chiropractor CurrentSince Jun 3, 2018 Accepting new patients

Locations

1 Florida Park Dr N
Ste 106
Palm Coast, FL 32137
Phone (386) 603-8001

9 Palm Harbor Village Way
Ste D
Palm Coast, FL 32137
Phone (386) 603-8001

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": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1841732112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22A PLATEAU LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321647439",
            "telephone_number": "386-986-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 PALM HARBOR VILLAGE WAY STE D",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "32137",
            "telephone_number": "138-660-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGO",
        "first_name": "JESSICA",
        "middle_name": "ALYSSE SANTOS",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-17",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 12011",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.