Lightning Mobile Wounds

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

LIGHTNING MOBILE WOUNDS

Practice address

2230 Reef Ave
Indialantic, FL 32903-2520

Phone

(703) 727-7171

NPI assigned

Jun 6, 2024

Last updated

Jun 11, 2024By 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

Denise Shepler

Title

Owner

Phone

(703) 727-7171

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718064000000",
    "number": "1265274740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 REEF AVE",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329032520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 REEF AVE",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329032520",
            "telephone_number": "703-727-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTNING MOBILE WOUNDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "SHEPLER",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-727-7171"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Indialantic, FL
• Providers in Indialantic, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.