Individual provider Active NPI

Jeffery Joseph Kromolicki, DC

  • Chiropractor
  • Trinity, FL
National Provider Identifier
1881668077
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0007844 Issued in FL
Practice address
8915 Mitchell Blvd
Trinity, FL 34655-4408
Phone
(727) 375-7557
Fax
(727) 375-9958
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0007844 FL Primary

Addresses

Primary practice location

8915 Mitchell Blvd
Trinity, FL 34655-4408

Mailing address

8915 Mitchell Blvd
Trinity, FL 34655-4408
Phone (727) 375-7557

Other identifiers 1

IdentifierTypeStateIssuer
381481500MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120411000684 FL Practitioner - Chiropractic 0042471435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2019 Little Rd
Trinity, FL 34655-4421

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0007844FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffery J. Kromolicki PA Chiropractor CurrentSince Jul 6, 2000 Accepting new patients

Locations

8915 Mitchell Blvd
Trinity, FL 34655
Phone (727) 375-7557

2019 Little Rd
Trinity, FL 34655
Phone (727) 375-7557

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1881668077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8915 MITCHELL BLVD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554408",
            "telephone_number": "727-375-7557",
            "fax_number": "727-375-9958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8915 MITCHELL BLVD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554408",
            "telephone_number": "727-375-7557",
            "fax_number": "727-375-9958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROMOLICKI",
        "first_name": "JEFFERY",
        "middle_name": "JOSEPH",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0007844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381481500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.