Organization Active NPI

Journey to Restoration, Inc.

Doing business as Journey to Restoration

  • Psychiatry Physician
  • Gainesville, FL
National Provider Identifier
1770339517
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
JOURNEY TO RESTORATION, INC.
Doing business as
Journey to Restoration
Practice address
4421 NW 39TH Ave
Building 3
Gainesville, FL 32606
Phone
(352) 380-0209
NPI assigned
Apr 24, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Authorized official

Name
San Chang, MDNPI 1821382730
Title
President
Phone
(352) 380-0209

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

4421 NW 39TH Ave
Building 3
Gainesville, FL 32606

Mailing address

4421 NW 39TH Ave
Building 3
Gainesville, FL 32606
Phone (352) 380-0209

Other names 1

  • Journey to Restoration Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1713916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1770339517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 NW 39TH AVE",
            "address_2": "BUILDING 3",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32606",
            "telephone_number": "352-380-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 NW 39TH AVE",
            "address_2": "BUILDING 3",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32606",
            "telephone_number": "352-380-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOURNEY TO RESTORATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "SAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-380-0209",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Journey to Restoration",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.