Impact Bodyworx, LLC

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Legal business name

IMPACT BODYWORX, LLC

Practice address

2575 Kurt St Ste 103
Eustis, FL 32726-6256

Phone

(352) 801-1523

NPI assigned

Dec 4, 2024

Organization subpart

No

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

Authorized official

Name

James Chadwick Gunter

Title

Owner

Phone

(352) 801-1523

Specialties & licenses 1

Addresses

Other names 1

• Impact BodyWorx Doing business as

Locations

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1174339246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 KURT ST STE 103",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266256",
            "telephone_number": "352-801-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 KURT ST STE 103",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266256",
            "telephone_number": "352-801-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT BODYWORX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "GUNTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CHADWICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-801-1523"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Impact BodyWorx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.