Coastal City Chiropractic Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

COASTAL CITY CHIROPRACTIC CENTER LLC

Practice address

4550 Clyde Morris Blvd Ste D
Port Orange, FL 32129-4080

Phone

(941) 504-2257

NPI assigned

Oct 18, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Chelsie Demaio, DCNPI 1639654387

Title

Chiropractic Physician

Phone

(941) 504-2257

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Chelsie Demaio, DC

  • Chiropractor
  • Port Orange, FL
  • NPI 1639654387
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539820800000",
    "number": "1871069732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 S ATLANTIC AVE APT A",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321276521",
            "telephone_number": "941-504-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 CLYDE MORRIS BLVD STE D",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294080",
            "telephone_number": "941-504-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CITY CHIROPRACTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-18",
        "last_updated": "2018-10-18",
        "status": "A",
        "authorized_official_last_name": "DEMAIO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "CHELSIE",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "941-504-2257",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felicia Clarke
• Sarah Clarke
• Brittany Michele Claude
• Jeffery Kyle Clifton, DC
• Clinical Acumen LLC.
• Coastal Medical Associates Inc
• Coastal Oaks Homecare Inc
• Coastline Family Medicine LLC
• Coastline Physical Therapy LLC
• Ronald Michael Coblentz

• Chiropractor in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; 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.