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ETHAN DEWEERD D.C
NPI 1679155444
Chiropractor in Brandon, FL

Active since April 22, 2021Accepts Medicare Assignment
1103 LITHIA PINECREST RD, BRANDON, FL 33511(813) 868-1138(813) 868-1137 Get Directions Write a Review

NPPES record last updated: April 22, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ethan Deweerd D.c NPPES

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

ETHAN DEWEERD D.C (NPI 1679155444) is an individual chiropractor in Brandon, Florida, licensed in Florida (CH12589) and active in the NPI registry since April 2021. He is a graduate of Palmer College Chiropractic - Davenport (2018).

NPPES Registry Identity

NPI1679155444
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameETHAN DEWEERDCredential: D.C
Location Address1103 LITHIA PINECREST RDBrandon, FL 33511-6713
Mailing Address1103 Lithia Pinecrest RdBrandon, FL 33511-6713 · (813) 868-1138 · Fax (813) 868-1137
Phone(813) 868-1138
Fax(813) 868-1137
Sole ProprietorNo
Medical School CMSPalmer College Chiropractic - DavenportGraduated 2018
Enumeration DateApril 22, 2021
NPPES CertifiedApril 22, 2021
✔ NPI 1679155444 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in FL · CH12589
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.
1103 LITHIA PINECREST RD, Brandon, FL 33511
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Florida, Inc., Florida Blue (BlueCross BlueShield FL) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ethan Deweerd D.c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082013974
PECOS Enrollment IDI20210526000644

Medicare Billing Reassignment

Medicare enrollment records show Ethan Deweerd reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Valrico Spine And Rehab Center
Same address
Chiropractor
1103 LITHIA PINECREST RD
Brandon, FL 33511
  • Reassigned Medicare billing, Florida enrollment
  • 4 clinicians in this Medicare group
NPI 1215363981 (813) 868-1138

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JUDY M SHEPHERD LCSW
Social Worker (Clinical)
1103 LITHIA PINECREST RD
BRANDON, FL 33511
Hillsborough County (813) 657-3550
VALRICO SPINE AND REHAB CENTER
Chiropractor
1103 LITHIA PINECREST RD
BRANDON, FL 33511
Hillsborough County (813) 868-1138
DR. ZACHARY STREET DC
Chiropractor
1103 LITHIA PINECREST RD
BRANDON, FL 33511
Hillsborough County (813) 868-1138
TERESA T REID LCSW
Specialist
1103 LITHIA PINECREST RD
BRANDON, FL 33511
Hillsborough County (813) 657-3550
VASILIOS NENOS DC
Chiropractor
1103 LITHIA PINECREST RD
BRANDON, FL 33511
Hillsborough County (813) 868-1138

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 Ethan Deweerd's NPI number?

The NPI number for Ethan Deweerd is 1679155444. It was assigned to this individual provider in the NPPES registry on April 22, 2021.

Where is Ethan Deweerd located?

Ethan Deweerd practices at 1103 Lithia Pinecrest Rd, Brandon, FL 33511. The listed phone number is (813) 868-1138.

What is Ethan Deweerd's specialty?

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

Is Ethan Deweerd enrolled in Medicare?

Yes. Ethan Deweerd is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Ethan Deweerd's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Deweerd reassigns Medicare benefits to Valrico Spine And Rehab Center (Brandon, FL). The 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 Ethan Deweerd's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ethan Deweerd accept?

Health plans from Cigna HealthCare of Florida, Inc., Cigna Healthcare, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Providence Health Plan and 2 other insurers list Ethan Deweerd as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ethan Deweerd was last updated on April 22, 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.