Active NPI
John D Lockenour, DC
- Orthopedic Chiropractor
- Port Orange, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Chiropractor
- License
- 9104
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100165920 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9104 | FL | MD | Orthopedic Chiropractor |
| 08000588A | IN | MD | Orthopedic Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John D Lockenour D C Inc | Orthopedic | Current | Accepting new patients |
| Palmer College Foundation | Current | Accepting new patients | |
| Clinical Acumen LLC. | Current | Accepting new patients | |
| Palmer College Foundation | Past | 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.
-
- Clinic/Center
- Port Orange, FL
- NPI 1801360870
-
- Chiropractor
- Port Orange, FL
- NPI 1568552255
-
- Chiropractor
- Bedford, IN
- NPI 1679615694
-
- Chiropractor
- Davenport, IA
- NPI 1174535181
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.