Gordon Family Chiropractic INC
Chiropractor in Ponte Vedra, FL. Organization (NPI-2).
NPI number1508304783
StatusActive
Last updated in NPPESFeb 7, 2017
Details
- NPI
- 1508304783
- Entity type
- Organization (NPI-2)
- Legal business name
- Gordon Family Chiropractic INC
- Organization subpart
- No
- Enumeration date
- Feb 7, 2017
- Last updated
- Feb 7, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | CH9576 | FL | Yes |
Practice location
228 Ponte Vedra Park DrSuite 800
Ponte Vedra, FL 32082-6613
Phone 904-418-3937
Mailing address
228 Ponte Vedra Park DrSuite 800
Ponte Vedra, FL 32082-6613
Phone 904-418-3937
Authorized official
Wayne Gordon
Manager
9044183937
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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