Individual provider Active NPI

Christy L Vergara, IBCLC, NBC-HWC

  • Health & Wellness Coach
  • Indian Harbour Beach, FL
National Provider Identifier
1306407218
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
License
275100 Issued in FL
Practice address
209 Freddie St
Indian Harbour Beach, FL 32937-2723
Phone
(575) 551-0527
NPI assigned
Jun 23, 2019
Last updated
Mar 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X 275100 FL Primary

Addresses

Primary practice location

209 Freddie St
Indian Harbour Beach, FL 32937-2723

Mailing address

209 Freddie St
Indian Harbour Beach, FL 32937-2723
Phone (321) 414-9197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
275100FLMDHealth & Wellness Coach

Practice roles

OrganizationSpecialtyStatusNew patients
Wellxperience, LLC Health & Wellness Coach CurrentSince Mar 11, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1561248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1306407218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 FREDDIE ST",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329372723",
            "telephone_number": "321-414-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 FREDDIE ST",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329372723",
            "telephone_number": "575-551-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGARA",
        "first_name": "CHRISTY",
        "middle_name": "L",
        "credential": "IBCLC, NBC-HWC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-23",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "FL",
            "license": "275100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Harbour Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; 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.