Organization Active NPI

Bennett Chiropractic and Wellness Center, Inc.

  • Chiropractor
  • Bonita Springs, FL
National Provider Identifier
1073796207
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8675 Issued in FL
Legal business name
BENNETT CHIROPRACTIC AND WELLNESS CENTER, INC.
Practice address
3645 Bonita Beach Rd Ste 4
Bonita Springs, FL 34134-4170
Phone
(239) 763-1288
Fax
(239) 319-5123
NPI assigned
Dec 11, 2007
Last updated
Sep 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Authorized official

Name
Dr. Nicole Michelle Bennett, DCNPI 1962463752
Title
President
Phone
(239) 763-1288

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH8675 FL Primary

Addresses

Primary practice location

3645 Bonita Beach Rd Ste 4
Bonita Springs, FL 34134-4170

Mailing address

3645 Bonita Beach Rd Ste 4
Bonita Springs, FL 34134-4170
Phone (239) 763-1288

Other identifiers 1

IdentifierTypeStateIssuer
381769501MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080418000293 FL Part B Supplier - Clinic/Group Practice 3375621154 Receives reassigned benefits from 1 practitioner
Practice locations: Bonita Springs, FL

National Provider Directory

National Provider Directory

Locations

3725 Bonita Beach Rd
Bonita Springs, FL 34134

3725 Bonita Beach Rd
Ste 4
Bonita Springs, FL 34134
Phone (239) 763-1288

6875 Estero Blvd
Ste A
Fort Myers Beach, FL 33931
Phone (239) 463-1640

7130 Estero Blvd
Unit 1
Fort Myers Beach, FL 33931
Phone (239) 463-1640

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": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790726400000",
    "number": "1073796207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 BONITA BEACH RD STE 4",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344170",
            "telephone_number": "239-763-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 BONITA BEACH RD STE 4",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344170",
            "telephone_number": "239-763-1288",
            "fax_number": "239-319-5123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENNETT CHIROPRACTIC AND WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-763-1288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381769501",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; 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.