FORT CAROLINE CLINIC OF CHIROPRACTIC
NPI 1104497361
Chiropractor in Jacksonville, FL
About Fort Caroline Clinic Of Chiropractic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FORT CAROLINE CLINIC OF CHIROPRACTIC (NPI 1104497361) is a healthcare organization registered as a chiropractor in Jacksonville, Florida and active in the NPI registry since July 2021. The organization lists Jeremy Brubaker, Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fort Caroline Clinic Of Chiropractic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Fort Caroline Clinic Of Chiropractic, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Fort Caroline Clinic Of Chiropractic's NPI number?
The NPI number for Fort Caroline Clinic Of Chiropractic is 1104497361. It was assigned to this organization in the NPPES registry on July 8, 2021.
Where is Fort Caroline Clinic Of Chiropractic located?
Fort Caroline Clinic Of Chiropractic is located at 12086 Fort Caroline Rd Ste 302, Jacksonville, FL 32225. The listed phone number is (904) 902-4325.
What is Fort Caroline Clinic Of Chiropractic's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Fort Caroline Clinic Of Chiropractic enrolled in Medicare?
Yes. Fort Caroline Clinic Of Chiropractic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Fort Caroline Clinic Of Chiropractic?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Fort Caroline Clinic Of Chiropractic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Fort Caroline Clinic Of Chiropractic was last updated on August 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Fort Caroline Clinic Of Chiropractic · NPI 1104497361
Chiropractor organization in Jacksonville, Florida. Organization record, active in the CMS NPPES registry since July 8, 2021.
## Identity
- **NPI:** 1104497361 (Entity type: Organization)
- **Enumerated:** July 8, 2021
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Organization subpart:** No
- **Authorized official:** Jeremy Brubaker, MEMBER
## Practice location
- **Address:** 12086 FORT CAROLINE RD STE 302, Jacksonville, FL 32225-7639
- **Phone:** (904) 902-4325
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Chiropractic) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 21, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1104497361) · Data from the CMS NPPES public registry.