Individual provider Active NPI

Brandon Levenick, D.C.

  • Chiropractor
  • Palm City, FL
National Provider Identifier
1013456359
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12090 Issued in FL
Practice address
3543 SW Corporate Pkwy
Palm City, FL 34990-8151
Phone
(772) 232-4091
NPI assigned
Feb 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12090 FL Primary

Addresses

Primary practice location

3543 SW Corporate Pkwy
Palm City, FL 34990-8151

Mailing address

931 SW Romaine LN
Port Saint Lucie, FL 34953-3605
Phone (248) 207-0176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170612000613 FL Practitioner - Chiropractic 0345518510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

434 NW Lake Whitney PL
Port Saint Lucie, FL 34986-2269
Phone (772) 232-4091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vital Wellness Chiropractic PA Chiropractor CurrentSince Feb 6, 2021 Accepting new patients

Locations

3543 SW Corporate Pkwy
Palm City, FL 34990
Phone (772) 221-8893

434 NW Lake Whitney Pl
Port St Lucie, FL 34986
Phone (772) 232-4091

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1013456359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 SW ROMAINE LN",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349533605",
            "telephone_number": "248-207-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3543 SW CORPORATE PKWY",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349908151",
            "telephone_number": "772-232-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVENICK",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-20",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.