Radiant Wellness Center LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

RADIANT WELLNESS CENTER LLC

Practice address

556 1St Ave N
St Petersburg, FL 33701-3702

Phone

(727) 954-5596

NPI assigned

May 14, 2020

Organization subpart

No

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

Authorized official

Name

Ashley Therese Martin, DCNPI 1841838620

Title

Owner/Dcotor

Phone

(843) 816-4274

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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 Therese Martin, DC

  • Chiropractor
  • St Petersburg, FL
  • NPI 1841838620
  Medicare reassignment NPD Authorized official
• Asimina Maria Georgiades, DC

  • Chiropractor
  • St Petersburg, FL
  • NPI 1689434177
  NPD
• Jacob Weaver, DC

  • Chiropractor
  • St Petersburg, FL
  • NPI 1720886278
  NPD

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1366064214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 13TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337015310",
            "telephone_number": "843-816-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 1ST AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013702",
            "telephone_number": "727-954-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "THERESE",
        "authorized_official_title_or_position": "OWNER/DCOTOR",
        "authorized_official_telephone_number": "843-816-4274",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ashley@theradiantwellnesscenter.com",
            "affiliation": "N",
            "address_1": "556 1st Ave N",
            "city": "St Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337013702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle M Rabinovitz, PTA
• Rachael Haskell PHD Resolution Today (Resolution Today)
• Sandra Marie Racine, ARNP
• John David Radford
• Radiant Minds Therapy & Wellness, LLC
• Radiation Oncology of West Florida
• Samantha C Radigan, PA-C
• Radiology Associates of Pinellas, LLC.
• Radiology Associates of St. Petersburg PA
• Radiology Associates of Tampa PA

• Clinic/Center in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.