Ponte Vedra Spine Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PONTE VEDRA SPINE CENTER LLC

Practice address

220 Ponte Vedra Park Dr Ste 180
Ponte Vedra Beach, FL 32082-6616

Phone

(937) 602-2092

NPI assigned

Oct 12, 2022

Organization subpart

No

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

Authorized official

Name

Gion Monn, DCNPI 1760098537

Title

Ceo

Phone

(937) 602-2095

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.

• Gion Monn, DC

  • Chiropractor
  • Seattle, WA
  • NPI 1760098537

  FL

  Medicare reassignment NPD Authorized official
• Sean Curtis Tracy, DC

  • Chiropractor
  • Ponte Vedra Beach, FL
  • NPI 1891223707
  NPD

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1225754294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 PONTE VEDRA PARK DR STE 180",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320826616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 PONTE VEDRA PARK DR STE 180",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320826616",
            "telephone_number": "937-602-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONTE VEDRA SPINE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "MONN",
        "authorized_official_first_name": "GION",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "937-602-2095",
        "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": []
}

• Ponte Vedra Orthodontics LLC
• Ponte Vedra Physical Therapy, Inc.
• Ponte Vedra Plastic Surgery, Inc
• Ponte Vedra Psychiatry LLC
• Ponte Vedra Psychologists, LLC
• Ponte Vedra Surgery Center
• Ponte Vedra Wellness Center Inc
• Amy Pope-Latham, LCSW
• Haille Marie Poppe, DPT
• Mary Katherine Porter, DNP

• Chiropractor in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.