Wholistic Medicine Clin

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

WHOLISTIC MEDICINE CLIN

Practice address

1405 SE Goldtree Dr
Suite D
Port St Lucie, FL 34952-7563

Phone

(772) 335-5022

Fax

(772) 335-5029

NPI assigned

Dec 28, 2006

Last updated

Sep 8, 2008By 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

Mr. William G Tye III

Title

Managing Partner

Phone

(772) 335-5022

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1619033362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 SE GOLDTREE DR",
            "address_2": "SUITE D",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527563",
            "telephone_number": "772-335-5022",
            "fax_number": "772-335-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 SE GOLDTREE DR",
            "address_2": "SUITE D",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527563",
            "telephone_number": "772-335-5022",
            "fax_number": "772-335-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLISTIC MEDICINE CLIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "TYE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "772-335-5022",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bri'Anne M White
• Jessica White, OTR
• Kenneth Ray White, PH.D.
• Laurel Ann White
• Shane Donald Whiteley, DC
• Wickshire Port St. Lucie
• Dennis Darnell Wideman II
• Alex Wilburn, LPTA
• Brandon Matthew Wildermuth, PHARMD
• Stacey Wilfork, RN

• Clinic/Center in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.