NPIMap

Organization Active NPI

Wesley Chapel Spine & Rehab LLC

Doing business as Wesley Chapel Spine & Sports Medicine

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1336721075
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WESLEY CHAPEL SPINE & REHAB LLC
Doing business as
Wesley Chapel Spine & Sports Medicine
Practice address
20433 Bruce B Downs Blvd
Tampa, FL 33647-2759
Phone
(813) 994-0151
NPI assigned
Apr 22, 2021
Last updated
Apr 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Authorized official

Name
Dr. Jason M Brooks, DCNPI 1316205859
Title
Owner
Phone
(813) 994-0151

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary
Acupuncturist 171100000X NU
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X NU
Sports Physical Therapist 2251S0007X NU

Addresses

Primary practice location

20433 Bruce B Downs Blvd
Tampa, FL 33647-2759

Mailing address

20433 Bruce B Downs Blvd
Tampa, FL 33647-2759
Phone (813) 994-0151

Other names 1

  • WESLEY CHAPEL SPINE & SPORTS MEDICINE Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL AirportPlazaSpineAndWellness@gmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210616000199 FL Part B Supplier - Clinic/Group Practice 3375943145 Receives reassigned benefits from 17 practitioners
Practice locations: Tampa, FL
O20210929000177 FL DME Supplier - Physician - Physical and Rehabilitation 3375943145 Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1336721075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20433 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472759",
            "telephone_number": "813-994-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20433 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472759",
            "telephone_number": "813-994-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY CHAPEL SPINE & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-994-0151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "AirportPlazaSpineAndWellness@gmail.com",
            "affiliation": "N",
            "address_1": "20433 Bruce B Downs Blvd",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336472759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "WESLEY CHAPEL SPINE & SPORTS MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.