New Wave Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH12446 Issued in FL

Legal business name

NEW WAVE CHIROPRACTIC LLC

Doing business as

Wild Life Chiropractic

Practice address

3150 N Wickham Rd Ste 5
Melbourne, FL 32935-2322

Phone

(321) 750-8850

Fax

(321) 256-5243

NPI assigned

Jul 5, 2018

Last updated

Apr 27, 2022By 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

Ashley Shiver Mincey, D.C.NPI 1831609536

Title

Owner

Phone

(321) 750-8850

Specialties & licenses 1

Addresses

Other names 1

• Wild Life Chiropractic Doing business as

Locations

Practitioners 1

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.

• Ashley Shiver Mincey, DC

  • Chiropractor
  • Melbourne, FL
  • NPI 1831609536
  Authorized official Same address or phone

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1326534058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 N WICKHAM RD STE 5",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352322",
            "telephone_number": "321-750-8850",
            "fax_number": "321-256-5243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N WICKHAM RD STE 5",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352322",
            "telephone_number": "321-750-8850",
            "fax_number": "321-256-5243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW WAVE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-05",
        "last_updated": "2022-04-27",
        "certification_date": "2022-02-14",
        "status": "A",
        "authorized_official_last_name": "MINCEY",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "SHIVER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-750-8850",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wild Life Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wild Life Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Tameka Newsome

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.