First Coast Spine & Rehab LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

FIRST COAST SPINE & REHAB LLC

Practice address

100 Whetstone PL Ste 310
St Augustine, FL 32086-5775

Phone

(904) 516-8600

NPI assigned

Jan 11, 2018

Organization subpart

No

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

Authorized official

Name

Jeneane Wakula

Title

Office Manager

Phone

(772) 546-9591

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515628800000",
    "number": "1740798776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8929 SE BRIDGE RD",
            "city": "HOBE SOUND",
            "state": "FL",
            "postal_code": "334555312",
            "telephone_number": "772-546-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WHETSTONE PL STE 310",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865775",
            "telephone_number": "904-516-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST SPINE & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-01-11",
        "status": "A",
        "authorized_official_last_name": "WAKULA",
        "authorized_official_first_name": "JENEANE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "772-546-9591"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Coast Pain and Spine Center LLC
• First Coast Pain Consultants PLLC
• First Coast Pain Management
• First Coast Physical Therapy Inc
• First Coast Pulmonary Associates
• First Coast Wound Care LLC
• First Step Counseling Center
• Ross H Fishman, D.M.D.
• Angela Diane Fitts, LCSW
• Joseph Michael Fitzgerald, FNP

• Chiropractor in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; 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.