Individual provider Active NPI

Daniel McBride, DC

  • Chiropractor
  • Kissimmee, FL
National Provider Identifier
1942361571
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7078 Issued in FL
Practice address
322 N John Young Pkwy
Kissimmee, FL 34741-4902
Phone
(407) 944-9355
Fax
(407) 933-1237
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7078 FL Primary

Addresses

Primary practice location

322 N John Young Pkwy
Kissimmee, FL 34741-4902

Mailing address

322 N John Young Pkwy
Kissimmee, FL 34741-4902
Phone (407) 944-9355

Other identifiers 2

IdentifierTypeStateIssuer
000854300MedicaidFL
55885OtherFLBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090429000323 FL Practitioner - Chiropractic 1052469145 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Space Coast Corporate Health Service P aGroup PAC ID 5799859831, 3 clinicians
Clow Integrated Medical Center PAGroup PAC ID 8820529118, 4 clinicians
Bradley J E Clow D C P aGroup PAC ID 0941361786, 3 clinicians

Practice addresses (Care Compare)

145 Palm Bay Nerd
Suite 120
West Melbourne, FL 32904-8601
Phone (321) 725-8778

145 Palm Bay Rd NE
Suite 120
West Melbourne, FL 32904-8601
Phone (321) 725-8778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH7078FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley J E Clow D C P a Chiropractor CurrentSince Mar 5, 2018 Accepting new patients
Clow Integrated Medical Center PA CurrentSince Sep 6, 2024 Accepting new patients
Space Coast Corporate Health Service P a Chiropractor CurrentSince Mar 5, 2018 Accepting new patients

Locations

145 Palm Bay Rd NE
Ste 120
West Melbourne, FL 32904
Phone (321) 725-8778

145 Palm Bay Rd NE
Ste 121
West Melbourne, FL 32904
Phone (321) 725-8778

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1942361571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414902",
            "telephone_number": "407-944-9355",
            "fax_number": "407-933-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414902",
            "telephone_number": "407-944-9355",
            "fax_number": "407-933-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000854300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "55885",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; 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.