Kustom Wellness, Inc

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

KUSTOM WELLNESS, INC

Doing business as

Kustom Wellness

Practice address

4550 Donald Ross Rd Ste 113
Palm Beach Gardens, FL 33418-5104

Phone

(561) 469-1558

NPI assigned

Aug 18, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tracy Kirkpatrick

Title

President

Phone

(561) 469-1558

Specialties & licenses 1

Addresses

Other names 1

• Kustom Wellness Doing business as

Locations

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1710403043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 DONALD ROSS RD STE 113",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334185104",
            "telephone_number": "561-469-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 DONALD ROSS RD STE 113",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334185104",
            "telephone_number": "561-469-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUSTOM WELLNESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KIRKPATRICK",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-469-1558",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kustom Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristin McCabe Counseling, LLC
• Mark R. Kruntorad
• James Kufdakis, M.D.
• Linda Ross Kushner, MA CCC, SLP
• Jazlyn Kussubagyo
• Nathaniel Der-Lin Kwok, MD
• Lindsay Labar, M.S., CCC-SLP
• Kayla Labranche
• Marie G Labranche, LMFT
• Queen Faithgy Labreton

• Pharmacy in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.