Organization Active NPI

St Johns Chiropractic, PLLC

Doing business as St. Johns Sport and Spine Chiropractic

  • Chiropractor
  • Saint Johns, FL
National Provider Identifier
1891383444
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ST JOHNS CHIROPRACTIC, PLLC
Doing business as
St. Johns Sport and Spine Chiropractic
Practice address
155 Bartram Market Dr Ste 113
St Johns, FL 32259-4582
Phone
(904) 290-1312
NPI assigned
Jan 8, 2021
Last updated
Sep 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Authorized official

Name
Dr. Chase Daniel Vanderpol, DCNPI 1255978441
Title
Owner
Phone
(904) 290-1312

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
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

155 Bartram Market Dr Ste 113
St Johns, FL 32259-4582

Mailing address

155 Bartram Market Dr Ste 113
Saint Johns, FL 32259-4582
Phone (904) 290-1312

Other names 1

  • St. Johns Sport and Spine Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210224002375 FL Part B Supplier - Clinic/Group Practice 6406261445 Receives reassigned benefits from 2 practitioners
Practice locations: St Johns, FL

National Provider Directory

National Provider Directory

Locations

155 Bartram Market Dr
Ste 113
St Johns, FL 32259
Phone (904) 290-1312

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": "1610064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789430400000",
    "number": "1891383444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 BARTRAM MARKET DR STE 113",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322594582",
            "telephone_number": "904-290-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 BARTRAM MARKET DR STE 113",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322594582",
            "telephone_number": "904-290-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHNS CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-08",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A",
        "authorized_official_last_name": "VANDERPOL",
        "authorized_official_first_name": "CHASE",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-290-1312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Johns Sport and Spine Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Johns Sport and Spine Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Johns, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.