ACTIVE CHIROPRACTIC, LLC (NPI# 1316961915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316961915 |
| Entity Type | Organization |
| Organization Name | ACTIVE CHIROPRACTIC, LLC |
| Practice Address |
1251 Hickory St Melbourne FL 32901-3221 |
| Practice Telephone | 3212553003 |
| Practice Fax Number | 3212553005 |
| Mailing Telephone | 3212553003 |
| Mailing Fax Number | 3212553005 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TODD B WASSMER (PRESIDENT) |
| Authorized Official Telephone | 3212553003 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CH9223 | FL | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497319776 | Active Chiropractic, LLC | Chiropractor | 2677 Willakenzie Rd Ste 8, Eugene, OR 97401-4873 | 2019-04-23 |
| 1558880849 | Active Chiropractic, LLC | Chiropractor | 28467 Us Highway 19 N Ste 302, Clearwater, FL 33761-4333 | 2017-09-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | ACTIVE CHIROPRACTIC, LLC | 2677 Willakenzie Road Suite 8, Eugene, OR 97401 |
| Street Address |
1251 HICKORY ST |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-3221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851347678 | Rafael Allende | Neurological Surgery | 1251 Hickory St, Melbourne, FL 32901-3221 | 2006-05-25 |
| 1548745037 | Kristin M. Kampenga | Physician Assistant | 1251 Hickory St, Melbourne, FL 32901-3221 | 2018-10-01 |
| 1245492040 | Denise Michele Holloway | Nurse Practitioner | 1251 Hickory St, Melbourne, FL 32901-3221 | 2008-07-02 |
| 1669564217 | Anthony J Dickerson | Physician Assistant | 1251 Hickory St, Melbourne, FL 32901-3221 | 2006-09-29 |
| 1821002684 | Wesley E Griffitt | Neurological Surgery | 1251 Hickory St, Melbourne, FL 32901-3221 | 2006-07-28 |
| 1659399129 | John M Gayden Jr. | Family Medicine | 1251 Hickory St, Melbourne, FL 32901-3221 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| 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 |
|---|---|---|---|---|
| 1942826938 | Michelle Stevens | Chiropractor | 5545 N Wickham Rd Ste 108, Melbourne, FL 32940-7323 | 2020-06-25 |
| 1104445048 | Edx of Brevard, LLC | Chiropractor | 2955 Pineda Plaza Way Ste 104, Melbourne, FL 32940-7306 | 2020-04-10 |
| 1619512944 | Alycia Bowles | Chiropractor | 8009 Glastonbury Pl, Melbourne, FL 32940-2141 | 2019-11-11 |
| 1497256663 | Amie Marie Wells | Chiropractor | 2314 Post Rd, Melbourne, FL 32935-2308 | 2018-02-23 |
| 1720592884 | Custom Chiropractic Services LLC | Chiropractor | 1710 Bryan St # 1, Melbourne, FL 32901-4412 | 2017-11-28 |
| 1376056291 | Mauricio Chiropractic Melbourne LLC | Chiropractor | 187 S Wickham Rd Ste 101, Melbourne, FL 32904-1123 | 2017-11-14 |
| 1548779150 | Leslie M Ryan | Chiropractor | 2255 N Wickham Rd Ste 109, Melbourne, FL 32935-8012 | 2017-09-26 |
| 1902341993 | Melbourne Chiropractic, Wellness & Rehab, LLC | Chiropractor | 1103 W Hibiscus Blvd, Suite 405, Melbourne, FL 32901-2714 | 2016-12-29 |
| 1336565621 | Bond Chiropractic Inc. | Chiropractor | 8059 Spyglass Hill Rd, Suite 102, Melbourne, FL 32940-8566 | 2014-03-11 |
| 1538585153 | Brandon Bond | Chiropractor | 7341 Office Park Pl Ste 202, Melbourne, FL 32940-8280 | 2014-03-06 |
| Find all providers in MELBOURNE | ||||
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| 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.