Unknown Individual – Sports Physician Chiropractor, NPI 1962589309

Unknown Individual is a healthcare provider. based in Fort pierce, Florida. specializing in Sports Physician Chiropractor. They hold a License No. CH6106 (FL). The NPI Number for Unknown Individual is 1962589309

Main info

Organization
Inactive
37 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1962589309
Phone
(772) 466-9575
Address
800 VIRGINIA AVE STE 45
Deactivation Date
3 April 2024

Doctor Profile

Medical School Name
LIFE CHIROPRACTIC COLLEGE
Secondary Phone
-
Graduation Year
1989 (37 years ago)
PAC ID
1658279443
Professional Enrollment ID
I20040105000031
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Virginia Avenue, Cortez Estates, Fort Pierce, St. Lucie County, Florida, 34943, United States

    FORT PIERCE, FL 349825893

    Phone: (772) 466-9575

    Fax: (772) 466-9475

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
98941Chiropractic manipulative treatment, 3-4 spinal regions48375$0
98940Chiropractic manipulative treatment, 1-2 spinal regions13847$0
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Insurance plans in this area (ZIP 34982)

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Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1962589309 in the public NPI dataset.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Sports Physician Chiropractor. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Fort Pierce, Florida as a primary anchor for Unknown Individual unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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