NPIMap

Organization Active NPI

Rejuvenx of West Palm Beach, LLC

  • Chiropractor
  • West Palm Beach, FL
National Provider Identifier
1144738550
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8849 Issued in FL
Legal business name
REJUVENX OF WEST PALM BEACH, LLC
Practice address
1645 Palm Beach Lakes Blvd Ste 1200
West Palm Beach, FL 33401-2214
Phone
(561) 422-1819
Fax
(561) 422-1819
NPI assigned
Jan 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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

Authorized official

Name
Timothy Decanio, DC
Title
Owner
Phone
(561) 422-1819

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH8849 FL Primary

Addresses

Primary practice location

1645 Palm Beach Lakes Blvd Ste 1200
West Palm Beach, FL 33401-2214

Mailing address

1470A Royal Palm Beach Blvd
Royal Palm Beach, FL 33411-1608
Phone (561) 422-1819

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516320000000",
    "number": "1144738550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470A ROYAL PALM BEACH BLVD",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334111608",
            "telephone_number": "561-422-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 PALM BEACH LAKES BLVD STE 1200",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012214",
            "telephone_number": "561-422-1819",
            "fax_number": "561-422-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENX OF WEST PALM BEACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-19",
        "last_updated": "2018-01-19",
        "status": "A",
        "authorized_official_last_name": "DECANIO",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-422-1819",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.