NPIMap

Organization Active NPI

Bain de Vie Cory Lake Isle LLC

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1891053294
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8562 Issued in FL
Legal business name
BAIN DE VIE CORY LAKE ISLE LLC
Practice address
10311 Cross Creek Blvd
Suite E
Tampa, FL 33647-2989
Phone
(813) 907-9898
Fax
(813) 907-0220
NPI assigned
Apr 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Authorized official

Name
Dr. Timothy Filmore Bain, D.O.
Title
President
Phone
(813) 907-9898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH8562 FL Primary

Addresses

Primary practice location

10311 Cross Creek Blvd
Suite E
Tampa, FL 33647-2989

Mailing address

10311 Cross Creek Blvd
Suite E
Tampa, FL 33647-2989
Phone (813) 907-9898

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1891053294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10311 CROSS CREEK BLVD",
            "address_2": "SUITE E",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472989",
            "telephone_number": "813-907-9898",
            "fax_number": "813-907-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10311 CROSS CREEK BLVD",
            "address_2": "SUITE E",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472989",
            "telephone_number": "813-907-9898",
            "fax_number": "813-907-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAIN DE VIE CORY LAKE ISLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "BAIN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "FILMORE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-907-9898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.