Active NPI
Wholistic Medicine Clinic, LLC
- Clinic/Center
- Fort Pierce, FL
National Provider Identifier
1750447405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- WHOLISTIC MEDICINE CLINIC, LLC
- Practice address
- 2401 Frist Blvd
Suite 7
Fort Pierce, FL 34950-4839 - Phone
- (772) 467-9043
- Fax
- (772) 464-6478
- NPI assigned
- Dec 28, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. William G Tye III
- Title
- Managing Partner
- Phone
- (772) 287-2677
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
2401 Frist Blvd
Suite 7
Fort Pierce, FL 34950-4839
Mailing address
2401 Frist Blvd
Suite 7
Fort Pierce, FL 34950-4839
Phone (772) 467-9043
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24565 | Other | FL | BLUECROSS BLUE SHIELD |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Physician
- Boynton Beach, FL
- NPI 1831255504
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1750447405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 FRIST BLVD",
"address_2": "SUITE 7",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349504839",
"telephone_number": "772-467-9043",
"fax_number": "772-464-6478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 FRIST BLVD",
"address_2": "SUITE 7",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349504839",
"telephone_number": "772-467-9043",
"fax_number": "772-464-6478"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WHOLISTIC MEDICINE CLINIC, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-28",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "TYE",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "MANAGING PARTNER",
"authorized_official_telephone_number": "772-287-2677",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "III"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUE SHIELD",
"identifier": "24565",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.