NPIMap

Organization Active NPI

Dr. Tristan Miceli, PLLC

Doing business as Pure Wellness

  • Chiropractor
  • Wellington, FL
National Provider Identifier
1083096648
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11108 Issued in FL
Legal business name
DR. TRISTAN MICELI, PLLC
Doing business as
Pure Wellness
Practice address
129 S State Road 7 Ste 402
Wellington, FL 33414-4379
Phone
(561) 469-6699
Fax
(561) 469-6636
NPI assigned
Jun 19, 2015
Last updated
Dec 3, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Authorized official

Name
Tristan Miceli, D.C.NPI 1124442702
Title
Chiropractor/Owner
Phone
(561) 469-6699

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 11108 FL Primary

Addresses

Primary practice location

129 S State Road 7 Ste 402
Wellington, FL 33414-4379

Mailing address

129 S State Road 7 Ste 402
Wellington, FL 33414-4379
Phone (561) 469-6699

Other names 1

  • Pure Wellness Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1434672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543795200000",
    "number": "1083096648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 S STATE ROAD 7 STE 402",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144379",
            "telephone_number": "561-469-6699",
            "fax_number": "561-469-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 S STATE ROAD 7 STE 402",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144379",
            "telephone_number": "561-469-6699",
            "fax_number": "561-469-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. TRISTAN MICELI, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-19",
        "last_updated": "2018-12-03",
        "status": "A",
        "authorized_official_last_name": "MICELI",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "561-469-6699",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "11108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pure Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.