Restore Injury Health Center

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

Legal business name

RESTORE INJURY HEALTH CENTER

Practice address

747 Fawn Ridge Dr Ste 100
Orange City, FL 32763-8268

Phone

(386) 259-9051

Fax

(386) 259-4243

NPI assigned

Jun 3, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Jasmine Perez, DC

Title

Owner

Phone

(386) 259-9051

Specialties & licenses 1

Addresses

Other names 1

• Restore Injury Health Center Other name

Locations

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1760006043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 FAWN RIDGE DR STE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638268",
            "telephone_number": "386-259-9051",
            "fax_number": "386-259-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 FAWN RIDGE DR STE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638268",
            "telephone_number": "386-259-9051",
            "fax_number": "386-259-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE INJURY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-259-9051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restore Injury Health Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Restore Injury Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.

Verify at the official NPI Registry.