Organization Active NPI

Love, Faith, Wellness, LLC

  • Nurse Practitioner
  • Brandon, FL
National Provider Identifier
1225855562
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
LOVE, FAITH, WELLNESS, LLC
Practice address
646 E Bloomingdale Ave
Brandon, FL 33511-8111
Phone
(813) 419-7911
Fax
(813) 291-7588
NPI assigned
Sep 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Tracy Chery, DNP, APRN-C
Title
DNP, Aprn-C
Phone
(813) 419-7911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

646 E Bloomingdale Ave
Brandon, FL 33511-8111

Mailing address

11948 Cross Vine Dr
Riverview, FL 33579-4312
Phone (786) 925-0745

Other names 1

  • Live In Vitality Wellness Center Doing business as

National Provider Directory

National Provider Directory

Locations

646 E Bloomingdale Ave
Brandon, FL 33511
Phone (813) 419-7911

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1225855562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11948 CROSS VINE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335794312",
            "telephone_number": "786-925-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 E BLOOMINGDALE AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118111",
            "telephone_number": "813-419-7911",
            "fax_number": "813-291-7588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVE, FAITH, WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "CHERY",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "DNP, APRN-C",
        "authorized_official_telephone_number": "813-419-7911",
        "authorized_official_credential": "DNP, APRN-C"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Live In Vitality Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.