Organization Active NPI

Specific Care Chiropractic Inc

  • Chiropractor
  • Lehigh Acres, FL
National Provider Identifier
1942321997
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0006739 Issued in FL
Legal business name
SPECIFIC CARE CHIROPRACTIC INC
Practice address
1169 Homestead Rd N
Lehigh Acres, FL 33936-6040
Phone
(239) 369-9109
Fax
(239) 369-4762
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jeffrey Michael Peck, D.C.NPI 1922014075
Title
Doctor
Phone
(239) 369-9109

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 CH0006739 FL Primary

Addresses

Primary practice location

1169 Homestead Rd N
Lehigh Acres, FL 33936-6040

Mailing address

1169 Homestead Rd N
Lehigh Acres, FL 33936-6040
Phone (239) 369-9109

Other identifiers 1

IdentifierTypeStateIssuer
380583200MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080110000001 FL Part B Supplier - Clinic/Group Practice 1557441052 Receives reassigned benefits from 6 practitioners
Practice locations: Cape Coral, FL; Fort Myers, FL; Lehgh Acres, FL

National Provider Directory

National Provider Directory

Locations

461 Del Prado Blvd S
Ste C
Cape Coral, FL 33990
Phone (239) 800-4149

1700 N University Dr
Ste 300301
Coral Springs, FL 33071
Phone (954) 688-9919

3949 Evans Ave
Ste 406
Fort Myers, FL 33901
Phone (239) 288-7274

403 Joan Ave N
Lehigh Acres, FL 33971
Phone (239) 369-9101

Practitioners & affiliated clinicians

Practitioners 12

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": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942321997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 HOMESTEAD RD N",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339366040",
            "telephone_number": "239-369-9109",
            "fax_number": "239-369-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 HOMESTEAD RD N",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339366040",
            "telephone_number": "239-369-9109",
            "fax_number": "239-369-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIFIC CARE CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "239-369-9109",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0006739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380583200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.