Organization Active NPI

Lakota Wellness, LLC

  • Family Medicine Physician
  • Ocoee, FL
National Provider Identifier
1396070041
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LAKOTA WELLNESS, LLC
Practice address
2910 Maguire Rd Suite 1009
Ocoee, FL 34761-4742
Phone
(407) 877-8707
Fax
(407) 877-7464
NPI assigned
Oct 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Authorized official

Name
Dr. Elyse Saltalamachia, DCNPI 1952520678
Title
Chiropractor-Managing Member
Phone
(407) 877-8707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

2910 Maguire Rd Suite 1009
Ocoee, FL 34761-4742

Mailing address

2910 Maguire Rd Suite 1009
Ocoee, FL 34761-4742
Phone (407) 877-8707

Other names 1

  • Lakota Medical Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091111000584 FL Part B Supplier - Clinic/Group Practice 9234277203 Receives reassigned benefits from 3 practitioners
Practice locations: Ocoee, FL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2154141Lakota Wellness2910 Maguire Rd Ste 1009, Ocoee, FL 34761Certificate of waiverSep 5, 2026

National Provider Directory

National Provider Directory

Locations

2910 Maguire Rd
Ste 1009
Ocoee, FL 34761
Phone (407) 877-8707

324 Moore Rd
Ocoee, FL 34761
Phone (407) 877-8707

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1396070041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 MAGUIRE RD SUITE 1009",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614742",
            "telephone_number": "407-877-8707",
            "fax_number": "407-877-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 MAGUIRE RD SUITE 1009",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614742",
            "telephone_number": "407-877-8707",
            "fax_number": "407-877-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKOTA WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-14",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "SALTALAMACHIA",
        "authorized_official_first_name": "ELYSE",
        "authorized_official_title_or_position": "CHIROPRACTOR-MANAGING MEMBER",
        "authorized_official_telephone_number": "407-877-8707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakota Medical",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Lakota Medical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ocoee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.