Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 111NN1001X | Chiropractor | Nutrition | X3467 | NEW YORK | No |
| 2 | 111NN1001X | Chiropractor | Nutrition | 3443 | NORTH CAROLINA | No |
| 3 | 111NS0005X | Chiropractor | Sports Physician | CH0004296 | FLORIDA | No |
| 4 | 111NS0005X | Chiropractor | Sports Physician | X3467 | NEW YORK | No |
| 5 | 111NS0005X | Chiropractor | Sports Physician | 3443 | NORTH CAROLINA | No |
| 6 | 111NN1001X | Chiropractor | Nutrition | CH0004296 | FLORIDA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | U12679 | MEDICARE UPIN | FLORIDA | |
| 2 | 22326 | OTHER | FLORIDA | BLUE CROSS BLUE SHIELD FL |
| 3 | 592895303 | OTHER | FLORIDA | FOCUS HEALTCARE NETWORK |
| 4 | 3500020270 | OTHER | FLORIDA | RAILROAD MEDICARE |
| 5 | 592895303 | OTHER | FLORIDA | HEALTHCARE NETWORKS OF AM |
| 6 | 592895303 | OTHER | FLORIDA | UNITEDHEALTHCARE |
| 7 | 22326 | MEDICARE ID-TYPE UNSPECIFIED | FLORIDA | |
| 8 | 1026594 | OTHER | FLORIDA | AMERICAN HEALTH SPECIALTY |
| 9 | 11115063 | OTHER | FLORIDA | MULTIPLAN |
| 10 | 1186957 | OTHER | FLORIDA | ACN |
| 11 | 59084110 | OTHER | FLORIDA | BLUE CROSS BLUE SHIELD AL |
| 12 | 592895303 | OTHER | FLORIDA | PHCS |
| 13 | 592895303 | OTHER | FLORIDA | TRIAD/OXFORD |
