Ascend Wellness Florida LLC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Legal business name

ASCEND WELLNESS FLORIDA LLC

Practice address

32 Killarney Ave
Saint Johns, FL 32259-9155

Phone

(631) 912-6418

NPI assigned

Dec 30, 2024

Organization subpart

No

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

Authorized official

Name

Ryan William Miller, CPT, CNC

Title

Ceo

Phone

(631) 912-6418

Specialties & licenses 1

Addresses

Other names 1

• Ascend Wellness Florida Other name

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1295543767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 KILLARNEY AVE",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322599155",
            "telephone_number": "631-912-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 KILLARNEY AVE",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322599155",
            "telephone_number": "631-912-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCEND WELLNESS FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "631-912-6418",
        "authorized_official_credential": "CPT, CNC"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascend Wellness Florida",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kayleigh Nicole Ansteatt, BCBA
• Lorraine Appiadu, PMHNP-BC
• Moyla Argandival
• Aroma Hair System
• Arts and Athletics Physical Therapy
• Ashleigh Hurd, CCC-SLP, LLC
• Pamela M Austin, PT
• Avecina Medical, PA
• Avecina Medical, PA
• Avecina Medical, PA

• All providers in Saint Johns, FL
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.