Individual provider Active NPI

Christopher Lee Terry, D.C.

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1922168871
Registry record updated Jun 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9307 Issued in FL
Practice address
4602 North Armenia Ave
Building D-3
Tampa, FL 33603
Phone
(813) 350-9100
Fax
(813) 374-8929
NPI assigned
Dec 11, 2006
Last updated
Jun 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9307 FL Primary

Addresses

Primary practice location

4602 North Armenia Ave
Building D-3
Tampa, FL 33603

Mailing address

500 Sunny Rd
Lakeland, FL 33801
Phone (863) 640-5344

Other identifiers 2

IdentifierTypeStateIssuer
76109OtherFLBCBS
382132300MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070830000233 FL Practitioner - Chiropractic 3678666062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiropractic Center of Lakeland South IncGroup PAC ID 6709946353, 3 clinicians

Practice addresses (Care Compare)

5227 US Hwy 98 S
Lakeland, FL 33812-4291
Phone (863) 709-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Center of Lakeland South, Inc Chiropractor CurrentSince Jan 5, 2019 Accepting new patients

Locations

5227 US Highway 98 S
Lakeland, FL 33812
Phone (863) 709-1600

Organizations & group practices 1

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1922168871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SUNNY RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33801",
            "telephone_number": "863-640-5344",
            "fax_number": "813-374-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 NORTH ARMENIA AVE",
            "address_2": "BUILDING D-3",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33603",
            "telephone_number": "813-350-9100",
            "fax_number": "813-374-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "CHRISTOPHER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "76109",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382132300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; 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.