Organization Active NPI

Nuwave Holistic Health Center PLLC

  • Chiropractor
  • St Augustine, FL
National Provider Identifier
1578423455
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
NUWAVE HOLISTIC HEALTH CENTER PLLC
Practice address
475 W Town PL Ste 115
Saint Augustine, FL 32092-3649
Phone
(904) 679-5406
Fax
(904) 679-5586
NPI assigned
Nov 13, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Authorized official

Name
Dr. Daniel Jacob Vish, DCNPI 1881132082
Title
Chiropractor/Owner
Phone
(904) 679-5406

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

475 W Town PL Ste 115
Saint Augustine, FL 32092-3649

Mailing address

659 Porta Rosa Cir
Saint Augustine, FL 32092-0456
Phone (412) 420-9053

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251201003740 FL Part B Supplier - Clinic/Group Practice 3870086622 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Augustine, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1762992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1578423455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 PORTA ROSA CIR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320920456",
            "telephone_number": "412-420-9053",
            "fax_number": "904-679-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 W TOWN PL STE 115",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923649",
            "telephone_number": "904-679-5406",
            "fax_number": "904-679-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUWAVE HOLISTIC HEALTH CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-13",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A",
        "authorized_official_last_name": "VISH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "904-679-5406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; 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.