NPIMap

Organization Active NPI

Holistic Family & Pain Management

  • Family Medicine Physician
  • Fort Pierce, FL
National Provider Identifier
1003145301
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME91383 Issued in FL
Legal business name
HOLISTIC FAMILY & PAIN MANAGEMENT
Practice address
1905 S 25TH St
Ste100
Fort Pierce, FL 34947-4739
Phone
(772) 467-9083
Fax
(772) 464-6478
NPI assigned
Dec 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. William G Tye III, DOM
Title
Owner
Phone
(772) 467-9083

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X ME91383 FL Primary

Addresses

Primary practice location

1905 S 25TH St
Ste100
Fort Pierce, FL 34947-4739

Mailing address

1905 S 25TH St
Ste100
Fort Pierce, FL 34947-4739
Phone (772) 467-9083

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1003145301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 S 25TH ST",
            "address_2": "STE100",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474739",
            "telephone_number": "772-467-9083",
            "fax_number": "772-464-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 S 25TH ST",
            "address_2": "STE100",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474739",
            "telephone_number": "772-467-9083",
            "fax_number": "772-464-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC FAMILY & PAIN MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-15",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "TYE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-467-9083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DOM"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME91383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.