Organization Active NPI

Pura Vida Chiropractic LLC

Doing business as Pura Vida Chiropractic

  • Chiropractor
  • Port Orange, FL
National Provider Identifier
1700359759
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PURA VIDA CHIROPRACTIC LLC
Doing business as
Pura Vida Chiropractic
Practice address
3959 S Nova Rd Ste 9
Port Orange, FL 32127-4900
Phone
(727) 220-6778
Fax
(386) 761-2522
NPI assigned
Jan 2, 2019
Last updated
Jan 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Authorized official

Name
Dr. Nicolle Jean Schultze, DCNPI 1912410838
Title
Owner
Phone
(727) 220-6778

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

3959 S Nova Rd Ste 9
Port Orange, FL 32127-4900

Mailing address

3959 S Nova Rd Ste 9
Port Orange, FL 32127-4900
Phone (727) 220-6778

Other names 1

  • Pura Vida Chiropractic Doing business as

National Provider Directory

National Provider Directory

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": "1546387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546387200000",
    "number": "1700359759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 S NOVA RD STE 9",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274900",
            "telephone_number": "727-220-6778",
            "fax_number": "386-761-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 S NOVA RD STE 9",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274900",
            "telephone_number": "727-220-6778",
            "fax_number": "386-761-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURA VIDA CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-02",
        "last_updated": "2019-01-02",
        "status": "A",
        "authorized_official_last_name": "SCHULTZE",
        "authorized_official_first_name": "NICOLLE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-220-6778",
        "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": [
        {
            "organization_name": "Pura Vida Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.