NPIMap

Organization Active NPI

Serenity Wellness and Family Practice LLC

  • Family Medicine Physician
  • Deland, FL
National Provider Identifier
1275313918
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SERENITY WELLNESS AND FAMILY PRACTICE LLC
Practice address
890 N Boundary Ave Ste 101
Deland, FL 32720-3173
Phone
(386) 873-4560
NPI assigned
Oct 2, 2023
Last updated
Oct 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Authorized official

Name
Michelle Rene Tutt, APRNNPI 1609407766
Title
Managing Owner
Phone
(386) 873-4560

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

890 N Boundary Ave Ste 101
Deland, FL 32720-3173

Mailing address

890 N Boundary Ave Ste 101
Deland, FL 32720-3173
Phone (386) 873-4560

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1275313918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 N BOUNDARY AVE STE 101",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203173",
            "telephone_number": "386-873-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 N BOUNDARY AVE STE 101",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203173",
            "telephone_number": "386-873-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY WELLNESS AND FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-01",
        "status": "A",
        "authorized_official_last_name": "TUTT",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "MANAGING OWNER",
        "authorized_official_telephone_number": "386-873-4560",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.