Advanced Spine and Wellness

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

CH9923 Issued in FL

Legal business name

ADVANCED SPINE AND WELLNESS

Practice address

1125 1St St S
Winter Haven, FL 33880-3902

Phone

(863) 293-0040

NPI assigned

Jun 23, 2014

Last updated

Jun 23, 2014By 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

Clark Lemmon, D.C.NPI 1023292612

Title

President

Phone

(863) 293-0040

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.

• Clark Jeffrey Lemmon, D.C.

  • Chiropractor
  • Winter Haven, FL
  • NPI 1023292612
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403481600000",
    "number": "1154736866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 1ST ST S",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803902",
            "telephone_number": "863-293-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 1ST ST S",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803902",
            "telephone_number": "863-293-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPINE AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-23",
        "status": "A",
        "authorized_official_last_name": "LEMMON",
        "authorized_official_first_name": "CLARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-293-0040",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "FL",
            "license": "CH9923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advance Rehab Clinic, Inc
• Advance Technological Radiology, PA
• Advanced Orthopedic Surgery
• Advanced Orthopedic Surgery of Celebration, LLC
• Advanced Rehab Clinic of Winter Haven
• Advanced Spine and Wellness
• Vriti Advani, MD
• Adventhealth Bond Clinic, Inc. (AdventHealth Bond Clinic)
• Adventhealth Bond Clinic, Inc. (AdventHealth Bond Clinic)
• Adventhealth Bond Clinic, Inc.

• Neurology Chiropractor in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Neurology Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; 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.