Rizen Wellness Lounge LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

RIZEN WELLNESS LOUNGE LLC

Practice address

1081 Town Center Dr Ste 200
Orange City, FL 32763-8360

Phone

(386) 218-0764

NPI assigned

Oct 10, 2024

Last updated

Dec 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Atia Gipson, NPNPI 1376259564

Title

Owner

Phone

(386) 218-0764

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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.

• Atia Gipson

  • Nurse Practitioner
  • Orange City, FL
  • NPI 1376259564
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735344000000",
    "number": "1083434559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 TOWN CENTER DR STE 200",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638360",
            "telephone_number": "386-218-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 TOWN CENTER DR STE 200",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638360",
            "telephone_number": "386-218-0764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIZEN WELLNESS LOUNGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A",
        "authorized_official_last_name": "GIPSON",
        "authorized_official_first_name": "ATIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-218-0764",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Gabriel Rivera Acevedo
• Antonio Clemente Rivera, RN
• Edmundo I Rivera, MD
• Jose Arnaldo Rivera, D.P.M
• Rebecca Rivetto, MA, BCBA
• Robert Erdman, D.D.S.,P.a.
• Robert P. Collette MD PA
• Brooke Alison Roberts
• Judy Jennifer Roberts, DO
• Taylor Roberts

• Family Nurse Practitioner in Orange City, FL
• Providers in Orange City, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2024; 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.