Integrative Medicine & Rehab LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

INTEGRATIVE MEDICINE & REHAB LLC

Practice address

9101 W College Pointe Dr Ste 1B
Fort Myers, FL 33919-3390

Phone

(239) 208-0088

NPI assigned

Mar 21, 2022

Organization subpart

No

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

Authorized official

Name

Drew Montez Clark, DC

Title

Owner

Phone

(239) 208-0088

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Drew-Montez Clark, D.C.

  • Chiropractor
  • Bonita Springs, FL
  • NPI 1982984969

  FL

  Medicare reassignment NPD
• Kristin Dearmond, DC

  • Chiropractor
  • Fort Myers, FL
  • NPI 1881105252

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698537600000",
    "number": "1699424374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 W COLLEGE POINTE DR STE 1B",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193390",
            "telephone_number": "239-208-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 W COLLEGE POINTE DR STE 1B",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193390",
            "telephone_number": "239-208-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE MEDICINE & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-21",
        "last_updated": "2023-10-29",
        "certification_date": "2023-10-29",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DREW",
        "authorized_official_middle_name": "MONTEZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-208-0088",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Fort Myers, FL
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2023; 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.