Organization Active NPI

St Cloud Chiropractic, Inc

  • Chiropractor
  • Saint Cloud, FL
National Provider Identifier
1912171943
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6290 Issued in FL
Legal business name
ST CLOUD CHIROPRACTIC, INC
Practice address
1106 10TH St
Suite B
Saint Cloud, FL 34769-3332
Phone
(407) 892-5008
Fax
(407) 892-5028
NPI assigned
Apr 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Authorized official

Name
Dr. John Francis Cullinane, D.C.NPI 1750384582
Title
President
Phone
(407) 892-5008

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 CH6290 FL Primary

Addresses

Primary practice location

1106 10TH St
Suite B
Saint Cloud, FL 34769-3332

Mailing address

PO Box 701757
Saint Cloud, FL 34770-1757
Phone (407) 892-5008

Other identifiers 2

IdentifierTypeStateIssuer
22605OtherFLBCBS
052561800MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090206000204 FL Part B Supplier - Clinic/Group Practice 2567526551 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Cloud, FL

National Provider Directory

National Provider Directory

Locations

1106 10th St
Ste B
Saint Cloud, FL 34769
Phone (407) 892-5008

Practitioners & affiliated clinicians

Practitioners 1

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": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295827200000",
    "number": "1912171943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 701757",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347701757",
            "telephone_number": "407-892-5008",
            "fax_number": "407-892-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 10TH ST",
            "address_2": "SUITE B",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347693332",
            "telephone_number": "407-892-5008",
            "fax_number": "407-892-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CLOUD CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2011-01-24",
        "status": "A",
        "authorized_official_last_name": "CULLINANE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-892-5008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "22605",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052561800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; 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.