Organization Active NPI

Rejuvenx of Boynton Beach LLC

  • Chiropractor
  • Boynton Beach, FL
National Provider Identifier
1669191656
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
REJUVENX OF BOYNTON BEACH LLC
Practice address
3200 S Congress Ave Ste 102
Boynton Beach, FL 33426-9041
Phone
(561) 422-1819
NPI assigned
Aug 24, 2022
Last updated
Aug 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Authorized official

Name
Dr. Timothy M Decanio, DCNPI 1770663486
Title
Owner
Phone
(561) 422-1819

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

3200 S Congress Ave Ste 102
Boynton Beach, FL 33426-9041

Mailing address

1470A Royal Palm Beach Blvd
Royal Palm Beach, FL 33411-1608
Phone (561) 422-1819

National Provider Directory

National Provider Directory

Locations

3200 S Congress Ave
Ste 102
Boynton Beach, FL 33426
Phone (561) 272-2000

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1669191656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470A ROYAL PALM BEACH BLVD",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334111608",
            "telephone_number": "561-422-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S CONGRESS AVE STE 102",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334269041",
            "telephone_number": "561-422-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENX OF BOYNTON BEACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "DECANIO",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-422-1819",
        "authorized_official_name_prefix": "Dr.",
        "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": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.