Shekinah Health & Wellness Center, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SHEKINAH HEALTH & WELLNESS CENTER, LLC

Practice address

305 Clyde Morris Blvd
Ormond Beach, FL 32174-8181

Phone

(561) 317-8454

NPI assigned

Nov 14, 2018

Last updated

Nov 15, 2018By 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

Moline J Blanc, PA-CNPI 1215306998

Title

Owner

Phone

(561) 317-8454

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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.

• Moline Jephtee Blanc

  • Physician Assistant
  • Orange City, FL
  • NPI 1215306998
  Medicare reassignment Authorized official
• Orjanette Marie Cooper-Bryant, APRN

  • Family Nurse Practitioner
  • Ormond Beach, FL
  • NPI 1013034388

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542240000000",
    "number": "1346719812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 CLYDE MORRIS BLVD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748181",
            "telephone_number": "561-317-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 CLYDE MORRIS BLVD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748181",
            "telephone_number": "561-317-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEKINAH HEALTH & WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-14",
        "last_updated": "2018-11-15",
        "status": "A",
        "authorized_official_last_name": "BLANC",
        "authorized_official_first_name": "MOLINE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-317-8454",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharpline Health PLLC (SharpLine Health)
• Ryan E Shaw, APRN
• SHC Home Health Services - Jacksonville, LLC (Signature HomeNow)
• Wallace Scott Shearon, LMFT
• Mary Sheirburn
• Shirl Denise Sheppard, MEDWAVIER PROVIDER
• Ronald W Sherman, DO
• Nicole Sherriff
• Shirah Psychiatry, LLC
• Steven Kyle Shirah, DNP

• Family Medicine Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.