NPIMap

Organization Active NPI

St Lucie Wellness and Rehab,LLC

  • Clinic/Center
  • Port Saint Lucie, FL
National Provider Identifier
1083322275
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ST LUCIE WELLNESS AND REHAB,LLC
Practice address
6981 Hancock Dr
Port Saint Lucie, FL 34952-8207
Phone
(772) 777-4869
NPI assigned
Nov 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Authorized official

Name
Decoste Christopher Jeudy
Title
Manager
Phone
(561) 460-4517

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

6981 Hancock Dr
Port Saint Lucie, FL 34952-8207

Mailing address

6981 Hancock Dr
Port Saint Lucie, FL 34952-8207
Phone (772) 777-4869

National Provider Directory

National Provider Directory

Locations

6981 Hancock Dr
Port Saint Lucie, FL 34952
Phone (772) 777-4869

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667779200000",
    "number": "1083322275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6981 HANCOCK DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349528207",
            "telephone_number": "772-777-4869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6981 HANCOCK DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349528207",
            "telephone_number": "772-777-4869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUCIE WELLNESS AND REHAB,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A",
        "authorized_official_last_name": "JEUDY",
        "authorized_official_first_name": "DECOSTE",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-460-4517"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.