Active NPI
Jacob Edward Stock, D.C.
- Chiropractor
- Punta Gorda, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH11900
- Practice address
- 2310 Tamiami TRL
Suite 2121
Punta Gorda, FL 33950-5932 - Phone
- (941) 205-2225
- Fax
- (941) 205-3000
- NPI assigned
- Nov 12, 2008
- Last updated
- Apr 25, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038011191 | IL | |
| Chiropractor | 111N00000X | CH11900 | FL | Primary |
Addresses
Primary practice location
2310 Tamiami TRL
Suite 2121
Punta Gorda, FL 33950-5932
Mailing address
2310 Tamiami TRL
Suite 2121
Punta Gorda, FL 33950-5932
Phone (941) 205-2225
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2310 Tamiami TRL
Unit 2121
Punta Gorda, FL 33950-5934
Phone (941) 205-2225
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH11900 | FL | MD | Chiropractor |
| 038011191 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pure Health Physical Medicine, LLC | Chiropractor | Current | Accepting new patients |
| Stock Chiropractic Wellness Center, P.a. | Chiropractor | Current | Accepting new patients |
Locations
2310 Tamiami Trl
Unit 2121
Punta Gorda, FL 33950
Phone (941) 205-2225
2116 W Galena Blvd
Ste 112
Aurora, IL 60506
Phone (630) 897-1895
Organizations & group practices 2
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.
-
- Chiropractor
- Punta Gorda, FL
- NPI 1548570799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493078400000",
"number": "1871747212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2310 TAMIAMI TRL",
"address_2": "SUITE 2121",
"city": "PUNTA GORDA",
"state": "FL",
"postal_code": "339505932",
"telephone_number": "941-205-2225",
"fax_number": "941-205-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2310 TAMIAMI TRL",
"address_2": "SUITE 2121",
"city": "PUNTA GORDA",
"state": "FL",
"postal_code": "339505932",
"telephone_number": "941-205-2225",
"fax_number": "941-205-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOCK",
"first_name": "JACOB",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-11-12",
"last_updated": "2017-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038011191",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH11900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Punta Gorda, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.