NPIMap

Organization Active NPI

Atlantic Wellness Center

  • Nutrition Chiropractor
  • New Smyrna Beach, FL
National Provider Identifier
1245335264
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
CH6443 Issued in FL
Legal business name
ATLANTIC WELLNESS CENTER
Practice address
225 N Causeway
New Smyrna Beach, FL 32169-5239
Phone
(386) 424-9977
Fax
(386) 423-3899
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Authorized official

Name
Dr. Keith J Engler, DCNPI 1629060611
Title
Owner
Phone
(386) 424-9977

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN1001X CH6443 FL Primary

Addresses

Primary practice location

225 N Causeway
New Smyrna Beach, FL 32169-5239

Mailing address

225 N Causeway
New Smyrna Beach, FL 32169-5239
Phone (386) 424-9977

Other identifiers 1

IdentifierTypeStateIssuer
380098900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070315000485 FL Part B Supplier - Clinic/Group Practice 7618070418 Receives reassigned benefits from 4 practitioners
Practice locations: New Smyrna Beach, FL

National Provider Directory

National Provider Directory

Locations

225 N Causeway
New Smyrna Beach, FL 32169
Phone (386) 409-7747

Practitioners 8

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": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310601600000",
    "number": "1245335264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N CAUSEWAY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321695239",
            "telephone_number": "386-424-9977",
            "fax_number": "386-423-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N CAUSEWAY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321695239",
            "telephone_number": "386-424-9977",
            "fax_number": "386-423-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2011-07-14",
        "status": "A",
        "authorized_official_last_name": "ENGLER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-424-9977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "FL",
            "license": "CH6443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380098900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.