Active NPI
Amanda Rodriguez-Medina
- Chiropractor
- Jacksonville, FL
National Provider Identifier
1841781671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH12501
- Practice address
- 6640 103Rd St
Jacksonville, FL 32210 - Phone
- (904) 317-6628
- NPI assigned
- May 29, 2018
- Sex
- Female
- 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 | CH12501 | FL | Primary |
Addresses
Primary practice location
6640 103Rd St
Jacksonville, FL 32210
Mailing address
4633 Greenbrook CT
Jacksonville, FL 32257-2452
Phone (787) 645-7810
Other practice location 1
4244 University Blvd S
Jacksonville, FL 32216-4975
Phone (904) 317-6628
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH12501 | FL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594944000000",
"number": "1841781671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4633 GREENBROOK CT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322572452",
"telephone_number": "787-645-7810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6640 103RD ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32210",
"telephone_number": "904-317-6628"
}
],
"practiceLocations": [
{
"address_1": "4244 University Blvd S",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322164975",
"country_code": "US",
"telephone_number": "904-317-6628",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODRIGUEZ-MEDINA",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-29",
"last_updated": "2020-07-17",
"certification_date": "2020-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH12501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.