NPIMap

Organization Active NPI

City for Life Wellness Clinic LLC

  • Chiropractor
  • Tamarac, FL
National Provider Identifier
1063008696
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CITY FOR LIFE WELLNESS CLINIC LLC
Practice address
6463 W Commercial Blvd
Tamarac, FL 33319-2110
Phone
(954) 488-2398
NPI assigned
Dec 17, 2020
Last updated
Oct 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Authorized official

Name
Dr. Gina McCarthy, D.C.NPI 1912335175
Title
Clinic Director
Phone
(954) 488-2398

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

6463 W Commercial Blvd
Tamarac, FL 33319-2110

Mailing address

6463 W Commercial Blvd
Tamarac, FL 33319-2110
Phone (954) 488-2398

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL ChiroTouch Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

6463 W Commercial Blvd
Tamarac, FL 33319
Phone (954) 488-2398

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": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1063008696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6463 W COMMERCIAL BLVD",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333192110",
            "telephone_number": "954-488-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6463 W COMMERCIAL BLVD",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333192110",
            "telephone_number": "954-488-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY FOR LIFE WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "954-488-2398",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "ChiroTouch",
            "affiliation": "N",
            "endpointDescription": "EHR Software",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6463 W Commercial Blvd",
            "city": "Tamarac",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333192110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.