Prime Impact Chiropractic, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PRIME IMPACT CHIROPRACTIC, INC

Doing business as

Thrive Restoration Clinic

Practice address

100 E Sybelia Ave Ste 217
Maitland, FL 32751-4757

Phone

(407) 887-6568

NPI assigned

Mar 3, 2023

Organization subpart

No

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

Authorized official

Name

Uche Ukeagu, DCNPI 1033599964

Title

Ceo

Phone

(954) 415-5931

Specialties & licenses 1

Addresses

Other names 1

• Thrive Restoration Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Uche Ukeagu

  • Chiropractor
  • Maitland, FL
  • NPI 1033599964
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1629778113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 MISTY OAKS RUN",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327072817",
            "telephone_number": "954-415-5931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E SYBELIA AVE STE 217",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514757",
            "telephone_number": "407-887-6568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME IMPACT CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "UKEAGU",
        "authorized_official_first_name": "UCHE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-415-5931",
        "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": [
        {
            "organization_name": "Thrive Restoration Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Maitland, FL
• Providers in Maitland, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.