Dougherty Chiropractic Clinic – Chiropractor, NPI 1770785412

Dougherty Chiropractic Clinic is a healthcare provider. based in New smyrna beach, Florida. specializing in Chiropractor. The organization holds a License No. CH9205 (FL). The NPI Number for Dougherty Chiropractic Clinic is 1770785412

Main info

Organization
Name
Dougherty Chiropractic Clinic
NPI
1770785412
Phone
(386) 423-5259
Address
1205 N DIXIE FWY
Authorized Official
DR. AMANDA JOY PROKOP MANAGER CHIROPRACTOR DC
Enumeration Date
4 June 2007
Last Update Date
21 January 2011
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Dougherty Chiropractic Clinic

  • 1205, Dixie Freeway, New Smyrna Beach, Volusia County, Florida, 32168, United States

    NEW SMYRNA BEACH, FL 321686005

    Phone: (386) 423-5259

    Fax: (386) 423-0929

    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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-10-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20071008000243OClinic/Group PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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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 32168)

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Reviews

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Frequently asked questions

Does Dougherty Chiropractic Clinic share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Dougherty Chiropractic Clinic uses 1770785412.
Is Dougherty Chiropractic Clinic still practicing?
Dougherty Chiropractic Clinic is currently listed as active in the public NPI registry.
What is Dougherty Chiropractic Clinic best known for clinically?
Directory data describes Dougherty Chiropractic Clinic with Chiropractor. Clinical services aligned with this taxonomy classification.
Where is Dougherty Chiropractic Clinic based?
Dougherty Chiropractic Clinic is tied to New Smyrna Beach, Florida in the data we show; additional addresses may exist on the full record.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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