Organization Active NPI

Optimum Wellness & Spine Rehabilitation Center

  • Chiropractor
  • Fort Pierce, FL
National Provider Identifier
1023408655
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9971 Issued in FL
Legal business name
OPTIMUM WELLNESS & SPINE REHABILITATION CENTER
Practice address
1805 S 25TH St
Fort Pierce, FL 34947-4752
Phone
(772) 448-8365
Fax
(772) 448-8341
NPI assigned
Feb 4, 2015
Last updated
Feb 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Authorized official

Name
Hermione B Jourdan, D.CNPI 1275850117
Title
Owner
Phone
(561) 512-5198

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9971 FL Primary

Addresses

Primary practice location

1805 S 25TH St
Fort Pierce, FL 34947-4752

Mailing address

1805 S. 25TH Street St. B
Fort Pierce, FL 34947
Phone (772) 448-8365

National Provider Directory

National Provider Directory

Locations

1805 S 25th St
Fort Pierce, FL 34947
Phone (772) 448-8365

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423008000000",
    "number": "1023408655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 S. 25TH STREET ST. B",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "34947",
            "telephone_number": "772-448-8365",
            "fax_number": "772-448-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474752",
            "telephone_number": "772-448-8365",
            "fax_number": "772-448-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM WELLNESS & SPINE REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-04",
        "last_updated": "2015-02-04",
        "status": "A",
        "authorized_official_last_name": "JOURDAN",
        "authorized_official_first_name": "HERMIONE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-512-5198",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9971",
            "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 Feb 4, 2015; 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.