NPIMap

Organization Active NPI

Wynne Chiropractic Inc.

Doing business as Wynne Chiropractic & Physical Therapy

  • Chiropractor
  • Lake Mary, FL
National Provider Identifier
1669465571
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 7382 Issued in FL
Legal business name
WYNNE CHIROPRACTIC INC.
Doing business as
Wynne Chiropractic & Physical Therapy
Practice address
365 Waymont CT
Suite 101
Lake Mary, FL 32746-3552
Phone
(407) 321-9191
Fax
(407) 321-9899
NPI assigned
Aug 25, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kevin G. Wynne, D.C.NPI 1710970686
Title
Owner
Phone
(407) 321-9191

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
Chiropractor 111N00000X CH 7382 FL Primary

Addresses

Primary practice location

365 Waymont CT
Suite 101
Lake Mary, FL 32746-3552

Mailing address

365 Waymont CT
Suite 101
Lake Mary, FL 32746-3552
Phone (407) 321-9191

Other names 1

  • WYNNE CHIROPRACTIC & PHYSICAL THERAPY Doing business as

National Provider Directory

National Provider Directory

Locations

365 Waymont Ct
Ste 101
Lake Mary, FL 32746
Phone (407) 321-9191

Practitioners & affiliated clinicians

Practitioners 2

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": "1124928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669465571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 WAYMONT CT",
            "address_2": "SUITE 101",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463552",
            "telephone_number": "407-321-9191",
            "fax_number": "407-321-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 WAYMONT CT",
            "address_2": "SUITE 101",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463552",
            "telephone_number": "407-321-9191",
            "fax_number": "407-321-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNNE CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WYNNE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-321-9191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 7382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WYNNE CHIROPRACTIC & PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.