Integrated Medical Centre of Bonita Springs Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH0005999 Issued in FL

Legal business name

INTEGRATED MEDICAL CENTRE OF BONITA SPRINGS INC

Doing business as

Accident and Injury Clinic

Practice address

28315 S Tamiami Trail
Suite 101
Bonita Springs, FL 34134

Phone

(239) 947-1177

Fax

(239) 947-6399

NPI assigned

Mar 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gary L Gendron, DCNPI 1982673547

Title

Owner Clinic Director

Phone

(239) 947-1177

Specialties & licenses 2

Addresses

Other names 1

• Accident and Injury Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 4

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

• Gary Laurence Gendron, DC

  • Chiropractor
  • Bonita Springs, FL
  • NPI 1982673547
  Medicare reassignment NPD Authorized official
• Kelly Marie Forte, APRN

  • Family Nurse Practitioner
  • Cape Coral, FL
  • NPI 1457953820
  NPD
• Susie Theresa Hemberger, ARNP

  • Adult Health Nurse Practitioner
  • Naples, FL
  • NPI 1942749627
  NPD
• Jennifer Renee Landberg, APRN

  • Family Nurse Practitioner
  • Delray Beach, FL
  • NPI 1922501139
  NPD

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1619946241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28315 S TAMIAMI TRAIL",
            "address_2": "SUITE 101",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "34134",
            "telephone_number": "239-947-1177",
            "fax_number": "239-947-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28315 S TAMIAMI TRAIL",
            "address_2": "SUITE 101",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "34134",
            "telephone_number": "239-947-1177",
            "fax_number": "239-947-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL CENTRE OF BONITA SPRINGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-16",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "GENDRON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER CLINIC DIRECTOR",
        "authorized_official_telephone_number": "239-947-1177",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0005999",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "CH0005870",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Accident and Injury Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Imed Diagnostic Services of Bonita Springs LLC
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• Inmotion Physical Therapy, LLC
• Innovative Pharmacy Solutions LLC
• Institutional Eye Care LLC
• Integrated Pain Solutions of Florida, PLLC
• Intercellular Sciences, LLC
• Interventional Rehabilitation of South Florida, Inc.
• Elena Theresa Ippolito
• Luckner Isme I

• Chiropractor in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.