NPIMap

Organization Active NPI

Atlantic Grove Chiropractic & Rehabilitation, Inc.

  • Chiropractor
  • Boca Raton, FL
National Provider Identifier
1891029294
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9743 Issued in FL
Legal business name
ATLANTIC GROVE CHIROPRACTIC & REHABILITATION, INC.
Practice address
7815 NW Beacon Square Blvd Ste 101
Boca Raton, FL 33487-1345
Phone
(561) 455-4850
Fax
(561) 995-0138
NPI assigned
Oct 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Authorized official

Name
Dr. Seyed Hessam Khatami, D.C.NPI 1659509891
Title
Owner
Phone
(561) 455-4850

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH9743 FL Primary

Addresses

Primary practice location

7815 NW Beacon Square Blvd Ste 101
Boca Raton, FL 33487-1345

Mailing address

7815 NW Beacon Square Blvd Ste 101
Boca Raton, FL 33487-1345
Phone (561) 455-4850

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100817001671 FL Part B Supplier - Clinic/Group Practice 6204960842 Receives reassigned benefits from 4 practitioners
Practice locations: Boca Raton, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1891029294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7815 NW BEACON SQUARE BLVD STE 101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334871345",
            "telephone_number": "561-455-4850",
            "fax_number": "561-995-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7815 NW BEACON SQUARE BLVD STE 101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334871345",
            "telephone_number": "561-455-4850",
            "fax_number": "561-995-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC GROVE CHIROPRACTIC & REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-01",
        "last_updated": "2023-11-28",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "KHATAMI",
        "authorized_official_first_name": "SEYED",
        "authorized_official_middle_name": "HESSAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-455-4850",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.