Lymphatic Wellness Center, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

LYMPHATIC WELLNESS CENTER, LLC

Practice address

2460 Old Moultrie Rd
Suite 4
St Augustine, FL 32086-4197

Phone

(904) 797-8787

Fax

(904) 797-8728

NPI assigned

Jun 13, 2006

Last updated

Aug 23, 2007By 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

Mr. Shaun Taylor Smith

Title

Owner/Operator

Phone

(904) 797-8787

Specialties & licenses 1

Addresses

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.

• Julie Watson

  • Occupational Therapist
  • St Augustine, FL
  • NPI 1457498479
  NPD (past)
• Brandy S McKeown, OTR/L, CLT-LANA

  • Occupational Therapist
  • Douglas, GA
  • NPI 1255348579
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187827200000",
    "number": "1386686186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 OLD MOULTRIE RD",
            "address_2": "SUITE 4",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864197",
            "telephone_number": "904-797-8787",
            "fax_number": "904-797-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 OLD MOULTRIE RD",
            "address_2": "SUITE 4",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864197",
            "telephone_number": "904-797-8787",
            "fax_number": "904-797-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYMPHATIC WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2007-08-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "904-797-8787",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Marie Lumsden
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• Vincent S Luz, MD
• Lyerly Baptist Inc
• Lynn M. Helder, PH.D., P.a.
• Cynthia Lyons, P.T., LMT
• Stephanie Lyons, LMT
• Marc Adam Macaluso
• Kaylie Macgregor, DPT

• Occupational Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; 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.