PROGRESSIVE CHIROPRACTIC AND REHABILITATION (NPI# 1053730218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053730218 |
Entity Type | Organization |
Organization Name | PROGRESSIVE CHIROPRACTIC AND REHABILITATION |
Practice Address |
502 S Main St Crestview FL 32536-4250 |
Practice Telephone | 8503988640 |
Practice Fax Number | 8503988641 |
Mailing Telephone | 8503988640 |
Mailing Fax Number | 8503988641 |
Enumeration Date | 2014-04-15 |
Last Update Date | 2014-04-15 |
Authorized Official Name | DR. JOEL A. TATE (CHIROPRACTIC PHYSICIAN/OWNER) |
Authorized Official Telephone | 3098309694 |
Authorized Official Credential | D.C. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH9929 | FL | Chiropractic Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | BLUE CROSS BLUE SHIELD PROVIDER NUMBER | 220C0 | 01 |
FL | MEDICAL LICENSE | CH9929 | 01 |
Street Address |
502 S MAIN ST |
City | CRESTVIEW |
State | FL |
Zip Code | 32536-4250 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962726703 | Joel A Tate | Chiropractor | 502 S Main St, Crestview, FL 32536-4250 | 2010-03-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831684901 | Eva Maria I Matute | Adult Companion | 6050 Trestle St, Crestview, FL 32536 | 2018-06-29 |
1669989232 | Lauren Estep Flowers | Physician Assistant | 550 Redstone Ave W Ste 370, Crestview, FL 32536 | 2018-01-04 |
1427444868 | Jessie Huisken | Social Worker | 5890 Saratoga Dr, Crestview, FL 32536 | 2015-04-13 |
1679846166 | John D. Carlson Md | Specialist | 492 North Wilson Street, Crestview, FL 32536 | 2012-02-15 |
1154609691 | Alternative Living, Inc. | Assisted Living Facility | 603 North Pearl Street, Crestview, FL 32536 | 2011-08-02 |
1487821526 | Michael G Foley Md Pa | Internal Medicine | 524 James Lee Blvd W, Crestview, FL 32536 | 2008-05-08 |
1184805830 | Advanced Family Medicine Clinic Inc | Family Medicine | 327 Medcrest Drive, Unit A, Crestview, FL 32536 | 2007-11-23 |
1164631511 | Caring Hearts Pediatric Extended Care Center, Inc | Clinic/Center | 380 Medcrest Dr, Crestview, FL 32536 | 2007-05-22 |
1669697751 | Crestview Chiropractic Clinic, Inc. | Chiropractor | 1078 S. Ferdon Boulevard, Suite A, Crestview, FL 32536 | 2007-04-16 |
1457492886 | Roy M Nakaiye | Dentist | 222 Cedar Ave, Crestview, FL 32536 | 2007-02-09 |
Find all providers in zip 32536 |
Taxonomy Code | 111N00000X |
Grouping | Chiropractic Providers |
Classification | Chiropractor |
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417309121 | Jaclyn Rawson | Chiropractor | 596 N Ferdon Blvd, Crestview, FL 32536-2753 | 2016-07-06 |
1962641548 | Moore's Chiropractic Health Clinic | Chiropractor | 502b S Ferdon Blvd, Crestview, FL 32536-4238 | 2009-02-05 |
1316164973 | Lloyd Cole Heisler | Chiropractor | 1695 S Ferdon Blvd, Crestview, FL 32536-8447 | 2007-04-18 |
1669697751 | Crestview Chiropractic Clinic, Inc. | Chiropractor | 1078 S. Ferdon Boulevard, Suite A, Crestview, FL 32536 | 2007-04-16 |
1265594170 | Healthy Living Chiropractic Center | Chiropractor | 924 N Ferdon Blvd, Crestview, FL 32536-1706 | 2006-12-15 |
1184792582 | Earl Moore | Chiropractor | 502 S Ferdon Blvd, Suite B, Crestview, FL 32536-4238 | 2006-12-01 |
1497798672 | Heather Rene Hankison | Chiropractor | 770 Industrial Dr, Crestview, FL 32539-2207 | 2006-06-14 |
1881152353 | Seaside Spine LLC | Chiropractor | 610 Hospital Dr, Crestview, FL 32539-7356 | 2019-03-04 |
1316446222 | Spine Life Chiropractic, LLC | Chiropractor | 1695 S Ferdon Blvd, Crestview, FL 32536-8447 | 2018-02-06 |
1689118218 | David Scott Rawson | Chiropractor | 596 N Ferdon Blvd, Crestview, FL 32536 | 2016-12-16 |
Find all providers in CRESTVIEW |
Please comment or provide details below to improve the information on PROGRESSIVE CHIROPRACTIC AND REHABILITATION.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.