Active Chiropractic Wellness Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH7715 Issued in FL

Legal business name

ACTIVE CHIROPRACTIC WELLNESS CENTER, LLC

Practice address

2570 Atlantic Blvd
Jacksonville, FL 32207-3604

Phone

(904) 398-4860

Fax

(904) 398-1785

NPI assigned

Aug 12, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Christopher Brian Renne, D.C.NPI 1508875378

Title

Owner

Phone

(904) 398-4860

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher Brian Renne, D.C.

  • Chiropractor
  • Jacksonville, FL
  • NPI 1508875378
  Medicare reassignment NPD Authorized official
• Jackie Renee Manning, ARNP

  • Family Nurse Practitioner
  • Lake City, FL
  • NPI 1265993091
  Medicare reassignment

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1982850830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073604",
            "telephone_number": "904-226-9110",
            "fax_number": "904-398-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073604",
            "telephone_number": "904-398-4860",
            "fax_number": "904-398-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE CHIROPRACTIC WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "RENNE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-398-4860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaissa Acosta
• Alexis Merrill Acra, MD
• Taylor Acres
• Action Disability Resources
• Action Disability Resources
• Active Corporate Care
• Active Health Care, PA
• Active Health Care, PA
• Active Spine Care LLC
• Acts of Virtue

• Chiropractor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.