Awaken Chiropractic Center Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

AWAKEN CHIROPRACTIC CENTER INC

Practice address

544 NW University Blvd Ste 103
Port St Lucie, FL 34986-2283

Phone

(772) 763-1311

NPI assigned

Oct 28, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Victoria Kustarz, DCNPI 1801318076

Title

Secretary

Phone

(772) 763-1311

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Victoria Kustarz, DC

  • Chiropractor
  • Port St Lucie, FL
  • NPI 1801318076
  Medicare reassignment Care Compare group NPD Authorized official
• Robert Matthew Kustarz, MS DC

  • Chiropractor
  • Port St Lucie, FL
  • NPI 1407378854
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1174167613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 NW UNIVERSITY BLVD STE 103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862283",
            "telephone_number": "772-763-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 NW UNIVERSITY BLVD STE 103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862283",
            "telephone_number": "772-763-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAKEN CHIROPRACTIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-28",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A",
        "authorized_official_last_name": "KUSTARZ",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "772-763-1311",
        "authorized_official_name_prefix": "Dr.",
        "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": []
}

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• Chiropractor in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.