Organization Active NPI

L & L Wellness LLC

Doing business as Dynamic Wellness & Chiropractic

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1417414467
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
L & L WELLNESS LLC
Doing business as
Dynamic Wellness & Chiropractic
Practice address
800 W Platt St Ste 2
Tampa, FL 33606-4112
Phone
(813) 551-1313
Fax
(813) 515-5079
NPI assigned
Feb 26, 2019
Last updated
Feb 26, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Authorized official

Name
Larry Wilson, DCNPI 1992171086
Title
Sole Owner
Phone
(813) 551-1313

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

800 W Platt St Ste 2
Tampa, FL 33606-4112

Mailing address

800 W Platt St Ste 2
Tampa, FL 33606-4112
Phone (813) 551-1313

Other names 1

  • Dynamic Wellness & Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190228000517 FL Part B Supplier - Clinic/Group Practice 7810236338 Receives reassigned benefits from 2 practitioners
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

800 W Platt St
Ste 2
Tampa, FL 33606
Phone (813) 515-5007

Practitioners & affiliated clinicians

Practitioners 4

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": "1551139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551139200000",
    "number": "1417414467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W PLATT ST STE 2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336064112",
            "telephone_number": "813-551-1313",
            "fax_number": "813-515-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W PLATT ST STE 2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336064112",
            "telephone_number": "813-551-1313",
            "fax_number": "813-515-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L & L WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-02-26",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "813-551-1313",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic Wellness & Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.