NPIMap

Organization Active NPI

Wellington Chiropractic Center of PBC

  • Chiropractor
  • Wellington, FL
National Provider Identifier
1699057083
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10273 Issued in FL
Legal business name
WELLINGTON CHIROPRACTIC CENTER OF PBC
Practice address
12797 Forest Hill Blvd Ste B
Wellington, FL 33414-4763
Phone
(561) 793-5550
NPI assigned
Sep 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Authorized official

Name
Matthew TavolacciNPI 1558686014
Title
President
Phone
(561) 793-5550

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 CH10273 FL Primary

Addresses

Primary practice location

12797 Forest Hill Blvd Ste B
Wellington, FL 33414-4763

Mailing address

12797 Forest Hill Blvd Ste B
Wellington, FL 33414-4763

National Provider Directory

National Provider Directory

Locations

12797 Forest Hill Blvd
Ste B
Wellington, FL 33414
Phone (561) 467-5232

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": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450051200000",
    "number": "1699057083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12797 FOREST HILL BLVD STE B",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12797 FOREST HILL BLVD STE B",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144763",
            "telephone_number": "561-793-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLINGTON CHIROPRACTIC CENTER OF PBC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2015-12-14",
        "status": "A",
        "authorized_official_last_name": "TAVOLACCI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-793-5550"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; 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.