Innove Chiro and Rehab, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

INNOVE CHIRO AND REHAB, PLLC

Practice address

224 SE 9TH St
Fort Lauderdale, FL 33316-1020

Phone

(563) 249-7446

Fax

(954) 827-0697

NPI assigned

Mar 6, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Blake Pennock II, DCNPI 1053877159

Title

Owner

Phone

(563) 249-7446

Specialties & licenses 1

Addresses

Other names 1

• Innove Chiro and Rehab, PLLC Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Blake Robert Pennock II, DC

  • Chiropractor
  • Flagstaff, AZ
  • NPI 1053877159
  NPD Authorized official

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1154021475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 SE 9TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161020",
            "telephone_number": "563-249-7446",
            "fax_number": "954-827-0697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 SE 9TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161020",
            "telephone_number": "563-249-7446",
            "fax_number": "954-827-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVE CHIRO AND REHAB, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "PENNOCK",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-249-7446",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innove Chiro and Rehab, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Providers in Fort Lauderdale, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.