Organization Active NPI

Live Well Chiropractic PLLC

  • Chiropractor
  • Davie, FL
National Provider Identifier
1710273065
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9974 Issued in FL
Legal business name
LIVE WELL CHIROPRACTIC PLLC
Practice address
4470 Weston Rd
Davie, FL 33331-3194
Phone
(954) 384-3275
NPI assigned
Jun 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Authorized official

Name
John Moore, DCNPI 1346365749
Title
Member/Manager
Phone
(954) 384-3275

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 9974 FL Primary

Addresses

Primary practice location

4470 Weston Rd
Davie, FL 33331-3194

Mailing address

4470 Weston Rd
Davie, FL 33331-3194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240304001026 FL Part B Supplier - Clinic/Group Practice 0749459428 Receives reassigned benefits from 2 practitioners
Practice locations: Sunrise, FL

National Provider Directory

National Provider Directory

Locations

4470 Weston Rd
Davie, FL 33331
Phone (954) 384-3275

5817 Lake Worth Rd
Greenacres, FL 33463
Phone (561) 642-9500

1330 SW 160th Ave
Sunrise, FL 33326
Phone (954) 384-3275

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308873600000",
    "number": "1710273065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4470 WESTON RD",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333313194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4470 WESTON RD",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333313194",
            "telephone_number": "954-384-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE WELL CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-24",
        "last_updated": "2011-06-24",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "954-384-3275",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "9974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.