Individual provider Active NPI

Brittin A Beaulieu, D.C.

  • Chiropractor
  • Clearwater, FL
National Provider Identifier
1962418152
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10085 Issued in FL
Practice address
2288 Drew St Ste C
Clearwater, FL 33765-3307
Phone
(727) 272-0501
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002280A IN
Chiropractor 111N00000X CH10085 FL Primary

Addresses

Primary practice location

2288 Drew St Ste C
Clearwater, FL 33765-3307

Mailing address

2171 Lagoon Dr
Dunedin, FL 34698-2529
Phone (727) 272-0501

Other identifiers 1

IdentifierTypeStateIssuer
200843480MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH10085FLMDChiropractor
08002280AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spinal Healthcare and Physical Medicine LLC PastSince Oct 6, 2016 Accepting new patients
Dupont Chiropractic Resource Center Inc. Chiropractor PastSince Jul 15, 2011 Accepting new patients
Chiropractic Resource Center Chiropractor Past Accepting new patients

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1962418152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2171 LAGOON DR",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346982529",
            "telephone_number": "727-272-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2288 DREW ST STE C",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653307",
            "telephone_number": "727-272-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAULIEU",
        "first_name": "BRITTIN",
        "middle_name": "A",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002280A",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200843480",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.