Atlas Wellness Group LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ATLAS WELLNESS GROUP LLC

Doing business as

Gulfside Chiropractic - Fort Myers

Practice address

9250 College Pkwy Ste 4
Fort Myers, FL 33919-4847

Phone

(239) 689-8495

Fax

(239) 308-0124

NPI assigned

Apr 29, 2021

Last updated

Apr 29, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

GULFSIDE CHIROPRACTIC HEALTH CENTERAs reported in NPPES

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

Authorized official

Name

Dr. Kimberly Anne Sanborn, DCNPI 1336672344

Title

Co-Owner

Phone

(239) 689-8495

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Gulfside Chiropractic - Fort Myers Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Part of

Gulfside Chiropractic Health Center

Locations

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.

• Gulfside Chiropractic Health Center

  • Chiropractor
  • Bonita Springs, FL
  • NPI 1295268910
  NPPES parent name

Practitioners 3

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.

• Kimberly Sanborn, D.C.

  • Chiropractor
  • Bonita Springs, FL
  • NPI 1336672344
  Medicare reassignment NPD Authorized official
• Emily Louise Flynn, D.C.

  • Chiropractor
  • Bonita Springs, FL
  • NPI 1093248007
  Medicare reassignment NPD
• Kreg Dale Sherman II, DC

  • Chiropractor
  • Bonita Springs, FL
  • NPI 1598299497
  Medicare reassignment NPD

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1679156517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 COLLEGE PKWY STE 4",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194847",
            "telephone_number": "239-689-8495",
            "fax_number": "239-308-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 COLLEGE PKWY STE 4",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194847",
            "telephone_number": "239-689-8495",
            "fax_number": "239-308-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLAS WELLNESS GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GULFSIDE CHIROPRACTIC HEALTH CENTER",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "SANBORN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "239-689-8495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARENT ORGANIZATION NPI",
            "identifier": "1295268910",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI - KIMBERLY SANBORN, DC",
            "identifier": "1336672344",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulfside Chiropractic - Fort Myers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carleather Atkins
• Marisol Camille Atkinson-Reno, LPN
• Crystal Atkinson
• Lauren Atkinson, PHARMD
• Todd Sterling Atkinson, M.D.
• Andrei V Atlivanau, PHARMD
• Rachel A Attenson, APRN
• Yamini Attiku, MBBS, MD
• Jenean Atway, PHARMD
• Audiology Consultants of Southwest Florida

• Chiropractor in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.