Individual provider Active NPI

John D Lockenour, DC

  • Orthopedic Chiropractor
  • Port Orange, FL
National Provider Identifier
1902889256
Registry record updated Jan 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
9104 Issued in FL
Practice address
5889 S Williamson Blvd
Suite 203
Port Orange, FL 32128-7134
Phone
(386) 689-4351
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X 08000588A IN
Orthopedic Chiropractor 111NX0800X 9104 FL Primary

Addresses

Primary practice location

5889 S Williamson Blvd
Suite 203
Port Orange, FL 32128-7134

Mailing address

2634 Spruce Creek Blvd
Port Orange, FL 32128-6781
Phone (386) 322-2544

Other identifiers 1

IdentifierTypeStateIssuer
100165920MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071023000279 FL Practitioner - Chiropractic 3274629183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John D Lockenour D C IncGroup PAC ID 1951459056, 2 clinicians

Practice addresses (Care Compare)

5889 S Williamson Blvd
Suite 212
Port Orange, FL 32128-7134
Phone (386) 689-4351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9104FLMDOrthopedic Chiropractor
08000588AINMDOrthopedic Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
John D Lockenour D C Inc Orthopedic CurrentSince Feb 26, 2008 Accepting new patients
Palmer College Foundation CurrentSince Apr 7, 2006 Accepting new patients
Clinical Acumen LLC. CurrentSince Oct 21, 2025 Accepting new patients
Palmer College Foundation PastSince Apr 7, 2006 Accepting new patients
Buch Chiropractic Inc Past Accepting new patients

Locations

5889 S Williamson Blvd
Ste 203
Port Orange, FL 32128
Phone (386) 689-4351

5889 S Williamson Blvd
Ste 212
Port Orange, FL 32128
Phone (386) 293-4348

4705 Clyde Morris Blvd
Pt Orange, FL 32129
Phone (386) 763-2712

Organizations & group practices 5

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232928000000",
    "number": "1902889256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2634 SPRUCE CREEK BLVD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321286781",
            "telephone_number": "386-322-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5889 S WILLIAMSON BLVD",
            "address_2": "SUITE 203",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321287134",
            "telephone_number": "386-689-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKENOUR",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2009-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "IN",
            "license": "08000588A",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "FL",
            "license": "9104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100165920",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; 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.