Nirvana Clinic Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

NIRVANA CLINIC INC

Practice address

9550-9 Baymeadows Road
Jacksonville, FL 32256

Phone

(904) 739-7398

Fax

(904) 739-3888

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Wille E Andre, PANPI 1639277734

Title

President Ceo

Phone

(904) 296-9090

Specialties & licenses 1

Addresses

Other names 1

• Nirvana Wellness Solutions Inc Former legal business name

Locations

Practitioners 4

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

• Wille E Andre, PA

  • Physician Assistant
  • Jacksonville, FL
  • NPI 1639277734
  NPD (past) Authorized official
• Latrese S Andre, PAC

  • Physician Assistant
  • Jacksonville, FL
  • NPI 1821196924
  NPD (past)
• Ahmad Ali Badii, MD

  • General Practice Physician
  • Jacksonville, FL
  • NPI 1225136328
  NPD (past)
• Roderick T Beaman Jr., D.O.

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1427002799
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205923174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PARKWAY SUITE 604",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-296-9090",
            "fax_number": "904-296-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550-9 BAYMEADOWS ROAD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-739-7398",
            "fax_number": "904-739-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIRVANA CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDRE",
        "authorized_official_first_name": "WILLE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "904-296-9090",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nirvana Wellness Solutions Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Ivana Preciosa Nina
• Nicole Varelas Ninesling, PSY.D.
• Anthony Nioso, MD
• Marlene Nioso
• Justin Nippert
• Erika Favors Nisbett, ARNP
• Rachel L Niskar
• Amber Niswander, PTA
• Jennifer Renee Nitz, OTR/L
• Nix Loving Angels LLC

• Multi-Specialty Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.