Individual provider Active NPI

Devin Casey Carrillo, DC

  • Chiropractor
  • Pensacola, FL
National Provider Identifier
1992260400
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH14423 Issued in FL
Practice address
1090 Scenic Hwy
Pensacola, FL 32503-6617
Phone
(850) 473-5555
NPI assigned
Feb 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X TX
Chiropractor 111N00000X CH14423 FL Primary

Addresses

Primary practice location

1090 Scenic Hwy
Pensacola, FL 32503-6617

Mailing address

1090 Scenic Hwy
Pensacola, FL 32503-6617
Phone (850) 473-5555

Other practice location 1

1449 W Nine Mile Rd Ste 5
Pensacola, FL 32534-5384
Phone (850) 473-5555

Other practice location 2

2200 Hickory St
Abilene, TX 79601-2345
Phone (214) 497-7555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230908000753 FL Practitioner - Chiropractic 8921462086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthsource of Northwest Florida LLCGroup PAC ID 0143387779, 6 clinicians

Practice addresses (Care Compare)

4650 Woodbine Rd
Pace, FL 32571-8717
Phone (850) 995-5773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthsource of Northwest Florida LLC Chiropractor CurrentSince May 19, 2023 Accepting new patients

Locations

4650 Woodbine Rd
Pace, FL 32571
Phone (850) 473-5555

1449 W Nine Mile Rd
Ste 5
Pensacola, FL 32534
Phone (850) 473-5555

2122 W Nine Mile Rd
Pensacola, FL 32534
Phone (850) 473-5555

1090 Scenic Hwy
Pensacola, FL 32503
Phone 8504735555 ext. 3

Organizations & group practices 1

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": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1992260400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 SCENIC HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325036617",
            "telephone_number": "850-473-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 SCENIC HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325036617",
            "telephone_number": "850-473-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1449 W Nine Mile Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325345384",
            "country_code": "US",
            "telephone_number": "850-473-5555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Hickory St",
            "address_purpose": "LOCATION",
            "city": "Abilene",
            "state": "TX",
            "postal_code": "796012345",
            "country_code": "US",
            "telephone_number": "214-497-7555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "DEVIN",
        "middle_name": "CASEY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-08",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.