NPIMap

Organization Active NPI

Inner Balance Family Medicine, LLC

  • Family Medicine Physician
  • Port Saint Lucie, FL
National Provider Identifier
1659932655
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INNER BALANCE FAMILY MEDICINE, LLC
Practice address
1400 SE Goldtree Drive
Suite 207
Port Saint Lucie, FL 34952-7583
Phone
(772) 323-0040
Fax
(772) 237-5849
NPI assigned
Jun 21, 2019
Organization subpart
Yes
Parent organization
INNER BALANCE FAMILY MEDICINE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Authorized official

Name
Dionne Layne Hinds, M.D.NPI 1154593184
Title
Owner
Phone
(772) 249-0636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1400 SE Goldtree Drive
Suite 207
Port Saint Lucie, FL 34952-7583

Mailing address

1400 SE Goldtree Drive
Suite 207
Port Saint Lucie, FL 34952-7583
Phone (772) 323-0040

Other names 1

  • Inner Balance Family Medicine, PA Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Inner Balance3 organizations share this tax ID, including this one
Part of
Inner Balance

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1659932655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SE GOLDTREE DRIVE",
            "address_2": "SUITE 207",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527583",
            "telephone_number": "772-323-0040",
            "fax_number": "772-237-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 SE GOLDTREE DRIVE",
            "address_2": "SUITE 207",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527583",
            "telephone_number": "772-323-0040",
            "fax_number": "772-237-5849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER BALANCE FAMILY MEDICINE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INNER BALANCE FAMILY MEDICINE, LLC",
        "enumeration_date": "2019-06-21",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "HINDS",
        "authorized_official_first_name": "DIONNE",
        "authorized_official_middle_name": "LAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-249-0636",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inner Balance Family Medicine, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Inner Balance Family Medicine, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.