Gulf Coast Spine & Sport, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH11255 Issued in FL

Legal business name

GULF COAST SPINE & SPORT, LLC

Practice address

6622 Willow Park Dr
Suite 202
Naples, FL 34109-9016

Phone

(636) 667-9150

NPI assigned

Jul 14, 2014

Last updated

Aug 6, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hillary Young, D.C.

Title

Chiropractic Physician

Phone

(636) 667-9150

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jack David Relue, DC

  • Chiropractor
  • Naples, FL
  • NPI 1598575656
  Medicare reassignment Care Compare group NPD
• Scott A Weiland, D.C.

  • Sports Physician Chiropractor
  • Naples, FL
  • NPI 1841568730
  Medicare reassignment Care Compare group NPD
• Lee Taylor Pinkham, DC

  • Sports Physician Chiropractor
  • Naples, FL
  • NPI 1336845791
  Medicare reassignment NPD

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407283200000",
    "number": "1245647007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6622 WILLOW PARK DR",
            "address_2": "SUITE 202",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341099016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6622 WILLOW PARK DR",
            "address_2": "SUITE 202",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341099016",
            "telephone_number": "636-667-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST SPINE & SPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-08-06",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "636-667-9150",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11255",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "FL",
            "license": "CH11220",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gulf Coast Home Care Services, Inc. (Associated Home Health)
• Gulf Coast Mobile Medicine, LLC
• Gulf Coast Mobility,Inc.
• Gulf Coast Respiratory Services LLC
• Gulf Coast Spine & Orthopaedic Institute PLLC
• Gulf Coast Telemedicine LLC
• Gulf Coast Therapy and Rehabilitation Center Inc
• Gulf Hearing Aid Center
• Gulf Shore Apothecary LLC (Gulf Shore Apothecary)
• Gulf Shore RX LLC (Gulf Shore Apothecary)

• Chiropractor in Naples, FL
• Providers in Naples, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.