Premier Wellness Centers LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH8221 Issued in FL

Legal business name

PREMIER WELLNESS CENTERS LLC

Practice address

10050 SW Innovation Way
Suite 201
Port St Lucie, FL 34987-2117

Phone

(772) 879-8700

Fax

(772) 879-8710

NPI assigned

Nov 3, 2008

Last updated

Mar 9, 2015By 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

William J Jensen, DCNPI 1992919922

Title

Owner

Phone

(772) 879-8700

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Premier Wellness Centers

  dba Premier Wellness Centers LLC

  • Chiropractor
  • Port Saint Lucie, FL
  • NPI 1194077347
  NPPES parent name

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William J Jensen, D.C.

  • Chiropractor
  • Port St Lucie, FL
  • NPI 1992919922
  Medicare reassignment Care Compare group Authorized official
• Kendall Blake Bloomer, DC

  • Chiropractor
  • Stuart, FL
  • NPI 1437901774
  Medicare reassignment Care Compare group NPD
• Kyle Hunter, DPT

  • Physical Therapist
  • Port St Lucie, FL
  • NPI 1730689381
  Medicare reassignment Care Compare group
• Mikenzi Pettenger, PT, DPT

  • Physical Therapist
  • Daytona Beach, FL
  • NPI 1093520850
  Medicare reassignment Care Compare group
• Andrea Gabriela Castro, DPT

  • Physical Therapist
  • Port Saint Lucie, FL
  • NPI 1740970532
  Medicare reassignment NPD
• Kyle Kemp, DC

  • Chiropractor
  • Palm Bay, FL
  • NPI 1225799414
  Medicare reassignment NPD
• Danielle Mendoza

  • Physical Therapist
  • Pembroke Pines, FL
  • NPI 1639827462
  Medicare reassignment NPD
• Mark Douglas Swart, PT

  • Physical Therapist
  • Port St Lucie, FL
  • NPI 1962655712
  Medicare reassignment NPD

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425859200000",
    "number": "1639322712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10050 SW INNOVATION WAY",
            "address_2": "SUITE 201",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872117",
            "telephone_number": "772-879-8700",
            "fax_number": "772-879-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10050 SW INNOVATION WAY",
            "address_2": "SUITE 201",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872117",
            "telephone_number": "772-879-8700",
            "fax_number": "772-879-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER WELLNESS CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-03",
        "last_updated": "2015-03-09",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-879-8700",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1992919922",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Premier Physical Therapy Sport Medicine Inc
• Premier Physical Therapy Sport Medicine Inc
• Premier Spine Specialists, LLC
• Premier Surgical Assisting LLC
• Premier Wellness Centers East LLC
• Premier Wellness Centers PSL
• Premise Health of Florida Medical PA (St Lucie - Port St Lucie)
• Premium Primary Care & Walk-in Clinic Inc
• Susan M Prendergast, ARNP
• Deanna Presti, PT

• Chiropractor in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; 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.