Jacksonville Health & Wellness CNTR.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH8960 Issued in FL

Legal business name

JACKSONVILLE HEALTH & WELLNESS CNTR.

Practice address

10950 San Jose Blvd Ste 14
Jacksonville, FL 32223-6671

Phone

(904) 268-6568

Fax

(904) 886-9804

NPI assigned

Nov 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jon M Repole, D.C.NPI 1447317391

Title

Owner and Practioner

Phone

(904) 268-6568

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 11

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

• Jon Michael Repole, D.C.

  • Nutrition Chiropractor
  • Jacksonville, FL
  • NPI 1447317391

  FL

  Medicare reassignment NPD Authorized official
• Adel S Bassel, M.D

  • General Practice Physician
  • Chattahoochee, FL
  • NPI 1619935541
  NPD (past)
• Timothy K Burnham, PA-C, MPAS

  • Medical Physician Assistant
  • Jacksonville, FL
  • NPI 1346210929
  NPD (past)
• Heather Fisse-Repole, LMHC, LMT

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1518352806
  NPD (past)
• Peter Anthony Fort, D.C

  • Chiropractor
  • Jacksonville, FL
  • NPI 1942356720
  NPD (past)
• Loubens Jean-Louis, PA-C

  • Physician Assistant
  • Jacksonville, FL
  • NPI 1164520995
  NPD (past)
• Michael R Medved, PA

  • Medical Physician Assistant
  • Saint Augustine, FL
  • NPI 1679690366
  NPD (past)
• Lawrence C Morris, DC

  • Chiropractor
  • Orange Park, FL
  • NPI 1952325888
  NPD (past)
• Raphael O Reyes, PA

  • Physician Assistant
  • Altamonte Springs, FL
  • NPI 1154365039
  NPD (past)
• Indrajit Verma, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Palatka, FL
  • NPI 1770583502
  NPD (past)
• Seung G Kim, D.C

  • Chiropractor
  • Macon, GA
  • NPI 1326129164
  NPD (past)

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1639350010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10950 SAN JOSE BLVD STE 14",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236671",
            "telephone_number": "904-268-6568",
            "fax_number": "904-886-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10950 SAN JOSE BLVD STE 14",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236671",
            "telephone_number": "904-268-6568",
            "fax_number": "904-886-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE HEALTH & WELLNESS CNTR.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "REPOLE",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER AND PRACTIONER",
        "authorized_official_telephone_number": "904-268-6568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "K9315",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacksonville FL Opco LLC
• Jacksonville Florida North, PLLC
• Jacksonville Foot Health Center
• Jacksonville Group Supply Inc
• Jacksonville Hand Associates P.a.
• Jacksonville Health Alliance, LLC
• Jacksonville Health Clinic PA
• Jacksonville Healthcare Group Inc
• Jacksonville Hospitalists PA
• Jacksonville Imaging Center, LLC

• All providers in Jacksonville, FL
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.