Unknown Individual – Chiropractor, NPI 1477536118

Unknown Individual is a healthcare provider. based in Port charlotte, Florida. specializing in Chiropractor. They hold a License No. CH0004243 (FL). The NPI Number for Unknown Individual is 1477536118

Main info

Organization
Inactive
44 Years Of Experience
Name
Unknown Individual
NPI
1477536118
Phone
(941) 629-8444
Address
795 CRESTVIEW CIR NW
Deactivation Date
13 June 2022

Doctor Profile

Medical School Name
LIFE CHIROPRACTIC COLLEGE
Secondary Phone
-
Graduation Year
1982 (44 years ago)
PAC ID
5890729834
Professional Enrollment ID
I20120111000771
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 795, Crestview Circle Northwest, Port Charlotte, Charlotte County, Florida, 33948, United States

    PORT CHARLOTTE, FL 339482126

    Phone: (941) 629-8444

    Fax: (941) 629-9513

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33948)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1477536118 when you need to reference Unknown Individual in forms, claims, or directories.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Chiropractor for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Port Charlotte, Florida because that is what the record indicates for Unknown Individual.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1477536118. Always confirm identity and privileges with the practice and licensing boards.

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Unknown Individual

Chiropractor
Peachland Boulevard, Port Charlotte, Charlotte County, Florida, 33954, United States
NPI: 1194881839