Integrated Chiropractic Wellness Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

INTEGRATED CHIROPRACTIC WELLNESS CENTER LLC

Practice address

1449 W Yamato Rd Ste 2
Boca Raton, FL 33431-4471

Phone

(561) 826-3808

Fax

(561) 826-3806

NPI assigned

Oct 22, 2020

Organization subpart

No

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

Authorized official

Name

Brandon Hollenberg, MDNPI 1851323166

Title

Owner

Phone

(561) 826-3808

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

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

• Brandon S. Hollenberg, D.C.

  • Chiropractor
  • Glen Burnie, MD
  • NPI 1851323166

  FL

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1437758299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1449 W YAMATO RD STE 2",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314471",
            "telephone_number": "561-826-3808",
            "fax_number": "561-826-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 W YAMATO RD STE 2",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314471",
            "telephone_number": "561-826-3808",
            "fax_number": "561-826-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED CHIROPRACTIC WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "HOLLENBERG",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-826-3808",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.