Organization Active NPI

Fluid Hydration & Wellness, PLLC

  • Health Service Clinic/Center
  • Charlotte, NC
National Provider Identifier
1154088391
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
FLUID HYDRATION & WELLNESS, PLLC
Practice address
1630 Oakhurst Commons Dr Suite 201
Ste 110
Charlotte, NC 28205-6382
Phone
(704) 258-3722
NPI assigned
Nov 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Cynthia AmbroiseNPI 1841831690
Title
Ceo
Phone
(704) 258-3722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

1630 Oakhurst Commons Dr Suite 201
Ste 110
Charlotte, NC 28205-6382

Mailing address

401 Hawthorne LN Ste 110200
Charlotte, NC 28204-2484
Phone (704) 258-3722

National Provider Directory

National Provider Directory

Locations

709 International Dr
Ste B
Charlotte, NC 28270
Phone (704) 652-2047

1630 Oakhurst Commons Dr
Ste 201
Charlotte, NC 28205
Phone (704) 258-3722

401 Hawthorne Ln
Ste 110200
Charlotte, NC 28204

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1154088391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HAWTHORNE LN STE 110200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042484",
            "telephone_number": "704-258-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 OAKHURST COMMONS DR SUITE 201",
            "address_2": "STE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056382",
            "telephone_number": "704-258-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLUID HYDRATION & WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-22",
        "last_updated": "2023-09-06",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "AMBROISE",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-258-3722"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

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