Organization Active NPI

Williamsburg Chiropractic and Wellness LLC

  • Chiropractor
  • Orlando, FL
National Provider Identifier
1154752764
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10519 Issued in FL
Legal business name
WILLIAMSBURG CHIROPRACTIC AND WELLNESS LLC
Practice address
5362 Central Florida Pkwy
Orlando, FL 32821-8772
Phone
(407) 239-1132
Fax
(407) 239-8859
NPI assigned
Dec 7, 2013
Last updated
May 6, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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

Authorized official

Name
Mohamed InshanNPI 1922372960
Title
Owner/Chiropractor
Phone
(407) 239-1132

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH10519 FL Primary

Addresses

Primary practice location

5362 Central Florida Pkwy
Orlando, FL 32821-8772

Mailing address

5362 Central Florida Pkwy
Orlando, FL 32821-8772
Phone (407) 239-1132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140506000045 FL Part B Supplier - Clinic/Group Practice 9436382074 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Locations

5410 Central Florida Pkwy
Orlando, FL 32821
Phone (407) 239-1132

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1386374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1154752764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5362 CENTRAL FLORIDA PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328218772",
            "telephone_number": "407-239-1132",
            "fax_number": "407-239-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5362 CENTRAL FLORIDA PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328218772",
            "telephone_number": "407-239-1132",
            "fax_number": "407-239-8859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSBURG CHIROPRACTIC AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-07",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "INSHAN",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "407-239-1132"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.