Saltwater Health & Wellness LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SALTWATER HEALTH & WELLNESS LLC

Practice address

260 Williamson Blvd # 731498
Ormond Beach, FL 32174-8257

Phone

(386) 319-2378

NPI assigned

Sep 1, 2020

Last updated

Sep 1, 2020By 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

Jordan Roberson, ARNP

Title

President

Phone

(386) 405-2823

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1437763125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 WILLIAMSON BLVD # 731498",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 WILLIAMSON BLVD # 731498",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748257",
            "telephone_number": "386-319-2378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALTWATER HEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-405-2823",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salem Homes of Florida, Inc. (Rosewood Avenue Group Home)
• Salem Villages MRDD, Inc.
• Timothy Sami Salib, DMD
• Eric Saltsberg, PH.D., C.PED., CFO
• Saltwater Family Practice
• Saltzman, Tanis, Pittell, Levin and Jacobson, LLC (Pediatric Associates)
• Eleni Samaan, DC
• Karen Lee Samuels, PH.D.
• Stephanie R Sanchez, ACNP-BC,FNP-BC, ARNP
• Stacyann Ellen Sanders, OTA

• Primary Care Clinic/Center in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.