NPIMap

Organization Active NPI

Xtreme Natural Body

  • Primary Care Clinic/Center
  • Orange Park, FL
National Provider Identifier
1376260190
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
XTREME NATURAL BODY
Practice address
534 Park Ave Ste 6
Orange Park, FL 32073-3109
Phone
(443) 846-9100
NPI assigned
Oct 24, 2022
Last updated
Mar 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Authorized official

Name
Mrs. Yvonne Marie Good, APRNNPI 1316240716
Title
Aprn / Owner
Phone
(443) 846-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

534 Park Ave Ste 6
Orange Park, FL 32073-3109

Mailing address

534 Park Ave Ste 6
Orange Park, FL 32073-3109
Phone (904) 999-1363

Other identifiers 2

IdentifierTypeStateIssuer
1316240716MedicaidFL
9432176OtherFLLICENSE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL xtremenaturalbody.com

National Provider Directory

National Provider Directory

Locations

1849 Dean Rd
Jacksonville, FL 32216
Phone (904) 994-8551

534 Park Ave
Ste 6
Orange Park, FL 32073
Phone (443) 846-9100

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1376260190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 PARK AVE STE 6",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733109",
            "telephone_number": "904-999-1363",
            "fax_number": "904-966-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 PARK AVE STE 6",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733109",
            "telephone_number": "443-846-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XTREME NATURAL BODY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-24",
        "last_updated": "2023-03-21",
        "certification_date": "2023-02-10",
        "status": "A",
        "authorized_official_last_name": "GOOD",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "APRN / OWNER",
        "authorized_official_telephone_number": "443-846-9100",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316240716",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "9432176",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "xtremenaturalbody.com",
            "affiliation": "N",
            "address_1": "534 Park Ave Ste 6",
            "city": "Orange Park",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320733109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.