Northeast Florida Wellness PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

NORTHEAST FLORIDA WELLNESS PLLC

Practice address

151 Sawgrass Corners Dr Ste 201
Ponte Vedra Beach, FL 32082-3579

Phone

(904) 395-5598

NPI assigned

Jan 18, 2024

Organization subpart

No

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

Authorized official

Name

Nathan Riddle, DCNPI 1104021310

Title

Owner

Phone

(904) 395-5598

Specialties & licenses 3

Addresses

Other names 1

• Riddle Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John H Linder, NP

  • Nurse Practitioner
  • Ponte Vedra Beach, FL
  • NPI 1730648569
  Medicare reassignment NPD
• Nathan Adam Riddle, D.C.

  • Chiropractor
  • Ponte Vedra Beach, FL
  • NPI 1104021310
  NPD Authorized official
• Megan N Scott Carlton, M.D.

  • Ophthalmology Physician
  • Ponte Vedra Beach, FL
  • NPI 1073957965
  NPD (past)

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1336900299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SAWGRASS CORNERS DR STE 201",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SAWGRASS CORNERS DR STE 201",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823579",
            "telephone_number": "904-395-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST FLORIDA WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-395-5598",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riddle Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catherine Nibi, R.PH.
• Kimberly McClure Nichols I, B.S.
• Norenberg & Associates LLC
• Eric J Norenberg, MD
• North Florida Surgeons, PA
• Renata Nosek, M.A.
• James November, PHD
• Elizabeth Cox Nurrenbrock, M.A. CCC-SLP
• Tracey O'Neill, CNS, LDN
• Occuplay Inc

• Physical Medicine & Rehabilitation Physician in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.