NPIMap

Organization Active NPI

Core Chiropractic & Spinal Rehab Center, LLC

  • Chiropractor
  • Port Orange, FL
National Provider Identifier
1992000376
Registry record updated Jan 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10194 Issued in FL
Legal business name
CORE CHIROPRACTIC & SPINAL REHAB CENTER, LLC
Practice address
4626 S Clyde Morris Blvd Ste 1
Port Orange, FL 32129-6402
Phone
(386) 523-1300
NPI assigned
Jan 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2011

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

Authorized official

Name
Dr. Gregory Brigola
Title
Chiropractic Physician
Phone
(386) 523-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH10194 FL Primary

Addresses

Primary practice location

4626 S Clyde Morris Blvd Ste 1
Port Orange, FL 32129-6402

Mailing address

4626 S Clyde Morris Blvd Ste 1
Port Orange, FL 32129-6402
Phone (386) 523-1300

National Provider Directory

National Provider Directory

Locations

4626 Clyde Morris Blvd
Ste 1
Port Orange, FL 32129
Phone (386) 492-2444

NPI Registry JSON

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

{
    "created_epoch": "1295222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295222400000",
    "number": "1992000376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4626 S CLYDE MORRIS BLVD STE 1",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296402",
            "telephone_number": "386-523-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4626 S CLYDE MORRIS BLVD STE 1",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296402",
            "telephone_number": "386-523-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE CHIROPRACTIC & SPINAL REHAB CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-17",
        "last_updated": "2011-01-17",
        "status": "A",
        "authorized_official_last_name": "BRIGOLA",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "386-523-1300",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2011; 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.