Colleen Hart

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH14962 Issued in FL

Practice address

955 W State Road 436 Ste 1040
Altamonte Springs, FL 32714-2917

Phone

(407) 403-5567

NPI assigned

Apr 11, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Revival Chiropractic LLC

  • Chiropractor
  • Altamonte Springs, FL
  • NPI 1215485511
  Medicare reassignment NPD

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1912751561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W STATE ROAD 436 STE 1040",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142917",
            "telephone_number": "407-403-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W STATE ROAD 436 STE 1040",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142917",
            "telephone_number": "407-403-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "COLLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Harris
• Brian E Harris, MD
• Tanna Lou Harris, M.ED.,C.C.C.,SLP
• Brandy L Harrison, LMT
• Kendra Michelle Harrison, APRN
• Todd Hartley, M.D.
• Randolf R Harvey, CRNA
• Nur Has
• Joseph Hawkins, LMHC
• Wael Fahmy Hawter

• Chiropractor in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.