Individual provider Active NPI

Nicolle J Schultze, D.C.

  • Chiropractor
  • Port Orange, FL
National Provider Identifier
1912410838
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
10469 Issued in FL
Practice address
3959 S Nova Rd Ste 9
Port Orange, FL 32127-4900
Phone
(727) 220-6778
NPI assigned
Nov 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 10469 FL Primary

Addresses

Primary practice location

3959 S Nova Rd Ste 9
Port Orange, FL 32127-4900

Mailing address

5609 Victoria Gardens Blvd Apt 1603
Port Orange, FL 32127-8975
Phone (727) 220-6778

Other practice location 1

187 S Wickham Rd Ste 101
Melbourne, FL 32904-1123
Phone (321) 372-5033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10469FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1912410838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5609 VICTORIA GARDENS BLVD APT 1603",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321278975",
            "telephone_number": "727-220-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 S NOVA RD STE 9",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274900",
            "telephone_number": "727-220-6778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "187 S Wickham Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329041123",
            "country_code": "US",
            "telephone_number": "321-372-5033",
            "fax_number": "321-372-5034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHULTZE",
        "first_name": "NICOLLE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-14",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "10469",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 2, 2019; 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.