Advanced Wellness & Sports Rehab, LLC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

CH10458 Issued in FL

Legal business name

ADVANCED WELLNESS & SPORTS REHAB, LLC

Practice address

14028 5TH St
Dade City, FL 33525

Phone

(352) 600-2232

Fax

(352) 292-0136

NPI assigned

Jun 15, 2012

Last updated

Feb 12, 2019By 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

Dr. Philip A Snyder, DCNPI 1942586466

Title

Owner

Phone

(724) 875-2460

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

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.

• Philip A Snyder, D.C.

  • Chiropractor
  • Dade City, FL
  • NPI 1942586466
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1134481005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14028 5TH ST",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335254311",
            "telephone_number": "352-600-2232",
            "fax_number": "352-292-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14028 5TH ST",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "33525",
            "telephone_number": "352-600-2232",
            "fax_number": "352-292-0136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14028 5th St",
            "address_purpose": "LOCATION",
            "city": "Dade City",
            "state": "FL",
            "postal_code": "33525",
            "country_code": "US",
            "telephone_number": "352-600-2232",
            "fax_number": "352-292-0136",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5413 George St Ste 1",
            "address_purpose": "LOCATION",
            "city": "New Port Richey",
            "state": "FL",
            "postal_code": "346524101",
            "country_code": "US",
            "telephone_number": "352-600-2232",
            "fax_number": "300-292-0136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED WELLNESS & SPORTS REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-15",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-875-2460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "FL",
            "license": "CH10458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mazen A Abboud, DPM
• Salam N Abdo, APRN
• Jade Alexis Abrams, RD, LD/N
• Miranda Adams, APRN, FNP-BC
• Yetunde O Adedeji, DDS
• Adventhealth Home Health and Hospice Inc (Adventhealth Home Health)
• Safi Uddin Ahmed, MD
• Danielle L Albritton, DO
• Angela Alcover, RCSWI
• Kayla Allen

• Sports Physician Chiropractor in Dade City, FL
• Providers in Dade City, FL by specialty
• Sports Physician Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.