ACTIVE CHIROPRACTIC, LLC (NPI# 1558880849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558880849 |
| Entity Type | Organization |
| Organization Name | ACTIVE CHIROPRACTIC, LLC |
| Other Organization Name | COUNTRYSIDE CHIROPRACTIC |
| Practice Address |
28467 Us Highway 19 N Ste 302 Clearwater FL 33761-4333 |
| Practice Telephone | (727) 216-6929 |
| Practice Fax Number | 7272166930 |
| Mailing Telephone | 7272166929 |
| Mailing Fax Number | 7272166930 |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2017-09-18 |
| Authorized Official Name | MRS. MARIA A YOUNG (OWNER) |
| Authorized Official Telephone | 7272166929 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | CH10813 | FL | Chiropractic Providers |
| Y | 111N00000X | Chiropractor | CH9770 | FL | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Countryside Chiropractic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497319776 | Active Chiropractic, LLC | Chiropractor | 2677 Willakenzie Rd Ste 8, Eugene, OR 97401-4873 | 2019-04-23 |
| 1316961915 | Active Chiropractic, LLC | Chiropractor | 1251 Hickory St, Melbourne, FL 32901-3221 | 2006-07-27 |
| 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 |
28467 US HIGHWAY 19 N STE 302 |
| City | CLEARWATER |
| State | FL |
| Zip Code | 33761-4333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184210 | Sandra Shanice Campisi | Behavior Technician | 29228 Us-19 N, Clearwater, FL 33761 | 2020-11-02 |
| 1659838449 | Branden Kleehammer | Occupational Therapy Assistant | 6941 300th Ave N, Clearwater, FL 33761 | 2019-02-27 |
| 1063901403 | Sheleaha C Egly I | Behavior Technician | 29288 Us Highway 19 N, Clearwater, FL 33761 | 2018-05-01 |
| 1760979629 | Melissa Irene Valentine | Social Worker | 6997 300th Ave North, Clearwater, FL 33761 | 2018-04-17 |
| 1871011049 | Maria's Adult Day Care Center | Clinic/Center | 26224 Us Highway 19 N., Clearwater, FL 33761 | 2017-09-07 |
| 1962933739 | Robert Hudson | Occupational Therapist | 3463 Northridge Dr, Clearwater, FL 33761 | 2017-03-23 |
| 1366985582 | Brandon Chad Brown | Physician Assistant | 29277 Hwy 19 North, Clearwater, FL 33761 | 2016-11-19 |
| 1730575606 | Layne S Winker | Physician Assistant | 26812 Us 19 N # 19, Clearwater, FL 33761 | 2015-04-08 |
| 1407254907 | M Christina Memoli Od Pa | Optometrist | 27901 Us 19 N, Clearwater, FL 33761 | 2014-12-15 |
| 1952729774 | Gina Pietras Spohn | Dermatology | 3165 N Mcmullen Booth Rd Bldg B, Clearwater, FL 33761 | 2014-03-29 |
| Find all providers in zip 33761 | ||||
| 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 |
|---|---|---|---|---|
| 1881234169 | Elite Injury Physicians LLC | Chiropractor | 4760 E Bay Dr Ste C, Clearwater, FL 33764-5703 | 2020-01-14 |
| 1164065439 | Scandy Chiropractic LLC | Chiropractor | 750 N Belcher Rd, Clearwater, FL 33765-2138 | 2019-10-19 |
| 1407407497 | Daniel Macdougall | Chiropractor | 205 N Garden Ave Fl 1, Clearwater, FL 33755-4121 | 2019-09-22 |
| 1437709102 | Christopher Sidney Ford Chance | Chiropractor | 974 Park St Apt 204, Clearwater, FL 33755-5524 | 2019-09-16 |
| 1700434974 | Anchor Sports Chiropractic LLC | Chiropractor | 2655 State Road 580 Ste 204, Clearwater, FL 33761-3167 | 2019-08-29 |
| 1942766233 | Allan G Keller Dc Pa | Chiropractor | 2467 Enterprise Rd Ste D, Clearwater, FL 33763-1724 | 2019-02-12 |
| 1982177721 | Donald Edgar John Leblanc | Chiropractor | 51 S Main Ave Ste 315, Clearwater, FL 33765-3934 | 2019-01-04 |
| 1841762531 | Fan Yang | Chiropractor | 4445 E Bay Dr Ste 302, Clearwater, FL 33764-6865 | 2018-12-19 |
| 1801389945 | Dr Vanessa Waugh D C LLC | Chiropractor | 611 Druid Rd E Ste 304, Clearwater, FL 33756-3919 | 2018-06-13 |
| 1912405523 | Mitchell Chiropractic Pa | Chiropractor | 1580 N Mcmullen Booth Rd, Clearwater, FL 33759-2595 | 2018-01-29 |
| Find all providers in CLEARWATER | ||||
| City | CLEARWATER |
| Zip Code | 33761 |
Please comment or provide details below to improve the information on ACTIVE CHIROPRACTIC, LLC.
| 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.