West Coast Wellness and Family Medicine PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

OS-9654 Issued in FL

Legal business name

WEST COAST WELLNESS AND FAMILY MEDICINE PA

Practice address

2512 Tamiami TRL N
Nokomis, FL 34275-3476

Phone

(941) 966-2342

Fax

(941) 966-5864

NPI assigned

Aug 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jess Harris Hawke, D.O.NPI 1134164742

Title

President

Phone

(941) 966-2342

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jess Hawke, D.O

  • Family Medicine Physician
  • Nokomis, FL
  • NPI 1134164742
  Medicare reassignment NPD Authorized official
• Craig Russell Allen, DO

  • General Practice Physician
  • Nokomis, FL
  • NPI 1760561914
  NPD (past)

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1013109974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 TAMIAMI TRL N",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342753476",
            "telephone_number": "941-966-2342",
            "fax_number": "941-966-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 TAMIAMI TRL N",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342753476",
            "telephone_number": "941-966-2342",
            "fax_number": "941-966-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST WELLNESS AND FAMILY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "HAWKE",
        "authorized_official_first_name": "JESS",
        "authorized_official_middle_name": "HARRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-966-2342",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "OS-9654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ember Lee Charlotte Wackelin
• Walgreen Co (Walgreens #11787)
• Anthony Warner, RCSWI
• Justin Ross Wasserman, MD
• Wellness U, LLC (Hope 80/20)
• Jennifer White
• Virginia Meredith Williams, MPT
• Brooke Wilson
• Jeffrey E Young, RPH
• Andrew Czeslaw Zaleski, MD

• Primary Care Clinic/Center in Nokomis, FL
• Providers in Nokomis, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.