NPIMap

Organization Active NPI

First Choice Chiropractic of Ormond, Inc

  • Chiropractor
  • Ormond Beach, FL
National Provider Identifier
1891005369
Registry record updated Feb 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8484 Issued in FL
Legal business name
FIRST CHOICE CHIROPRACTIC OF ORMOND, INC
Practice address
800 Sterthaus Dr
Suite a
Ormond Beach, FL 32174-5132
Phone
(386) 310-7246
Fax
(386) 310-4952
NPI assigned
Oct 18, 2010
Last updated
Feb 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2012

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

Authorized official

Name
Dr. Brad Tepper, DCNPI 1982916391
Title
President
Phone
(386) 310-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CH8484 FL Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CH10046 FL
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CH10229 FL

Addresses

Primary practice location

800 Sterthaus Dr
Suite a
Ormond Beach, FL 32174-5132

Mailing address

800 Sterthaus Dr
Suite a
Ormond Beach, FL 32174-5132
Phone (386) 310-7246

Other identifiers 1

IdentifierTypeStateIssuer
001E5OtherFLBCBSFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110715000162 FL Part B Supplier - Clinic/Group Practice 5294903381 Receives reassigned benefits from 1 practitioner
Practice locations: Holly Hill, FL

National Provider Directory

National Provider Directory

Locations

1721 Ridgewood Ave
Ste A
Holly Hill, FL 32117
Phone (386) 310-7246

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329523200000",
    "number": "1891005369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 STERTHAUS DR",
            "address_2": "SUITE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745132",
            "telephone_number": "386-310-7246",
            "fax_number": "386-310-4952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 STERTHAUS DR",
            "address_2": "SUITE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745132",
            "telephone_number": "386-310-7246",
            "fax_number": "386-310-4952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CHOICE CHIROPRACTIC OF ORMOND, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2012-02-18",
        "status": "A",
        "authorized_official_last_name": "TEPPER",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-310-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8484",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10046",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10229",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "001E5",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2012; 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.