Individual provider Active NPI

Steven Wyckoff, DC

  • Chiropractor
  • St Petersburg, FL
National Provider Identifier
1912905662
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8283 Issued in FL
Practice address
3348 Tyrone Blvd N
St Petersburg, FL 33710-2340
Phone
(727) 381-7433
Fax
(727) 381-7434
NPI assigned
Jul 7, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH8283 FL Primary

Addresses

Primary practice location

3348 Tyrone Blvd N
St Petersburg, FL 33710-2340

Mailing address

3348 Tyrone Blvd N
St Petersburg, FL 33710-2340
Phone (727) 381-7433

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110120000583 FL Practitioner - Chiropractic 1951337989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2117 49TH St N
Saint Petersburg, FL 33710-5233
Phone (727) 381-7433

3348 Tyrone Blvd N
Saint Petersburg, FL 33710-2340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH8283FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Scow of Florida, LLC Chiropractor CurrentSince Aug 21, 2010 Accepting new patients
Florida Chiropractic Clinics Inc Chiropractor PastSince Oct 1, 2002 Accepting new patients

Locations

2117 49th St N
St Petersburg, FL 33710
Phone (727) 321-3058

3348 Tyrone Blvd N
St Petersburg, FL 33710
Phone (616) 800-9928

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912905662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3348 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337102340",
            "telephone_number": "727-381-7433",
            "fax_number": "727-381-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3348 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337102340",
            "telephone_number": "727-381-7433",
            "fax_number": "727-381-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYCKOFF",
        "first_name": "STEVEN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.