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REVOLUTION CHIROPRACTIC LLC
NPI 1124576566
Chiropractor in Jacksonville, FL

Active since September 14, 2016
14866 OLD ST AUGUSTINE ROAD, SUITE 113, JACKSONVILLE, FL 32258(904) 716-1098 Get Directions Write a Review

NPPES record last updated: September 14, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Revolution Chiropractic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVOLUTION CHIROPRACTIC LLC (NPI 1124576566) is a healthcare organization registered as a chiropractor in Jacksonville, Florida and active in the NPI registry since September 2016. The organization lists Lauren Ashley Cost, Owner, as its authorized official.

NPPES Registry Identity

NPI1124576566
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameREVOLUTION CHIROPRACTIC LLC
Location Address14866 OLD ST AUGUSTINE ROAD, SUITE 113Jacksonville, FL 32258
Mailing Address313 Summer Springs CtJacksonville, FL 32225-4186 · (904) 716-1098
Phone(904) 716-1098
Organization SubpartNo
Authorized OfficialLauren Ashley CostOwner · (904) 716-1098
Enumeration DateSeptember 14, 2016
✔ NPI 1124576566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in FL · 11821
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
14866 OLD ST AUGUSTINE ROAD, Jacksonville, FL 32258
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Revolution Chiropractic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Revolution Chiropractic LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Lauren Cost, D.C.
Chiropractic
NPI 1326595927
14866 OLD ST. AUGUSTINE ROAD SUITE 113
Jacksonville, FL 32258
(904) 348-0039
✔ Accepts MedicareSame address
Ekaterina Medina, DC
Chiropractic
NPI 1275104697
14866 OLD SAINT AUGUSTINE RD STE 103
Jacksonville, FL 32258
(904) 348-0039
✔ Accepts MedicareSame address
Bethanie Hansen, D.C.
Chiropractic
NPI 1538661202
2125 PACE ST STE B
Covington, GA 30014
(770) 786-2818
✔ Accepts Medicare275 mi

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 Revolution Chiropractic LLC's NPI number?

The NPI number for Revolution Chiropractic LLC is 1124576566. It was assigned to this organization in the NPPES registry on September 14, 2016.

Where is Revolution Chiropractic LLC located?

Revolution Chiropractic LLC is located at 14866 Old St Augustine Road Suite 113, Jacksonville, FL 32258. The listed phone number is (904) 716-1098.

What is Revolution Chiropractic LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Revolution Chiropractic LLC enrolled in Medicare?

Yes. Revolution Chiropractic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revolution Chiropractic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Chiropractic, reassign their Medicare billing to Revolution Chiropractic LLC. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Revolution Chiropractic LLC was last updated on September 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.