NPIMap

Organization Active NPI

Pure Chiropractic & Natural Health, PA

  • Chiropractor
  • Lake Mary, FL
National Provider Identifier
1780006403
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH3063 Issued in FL
Legal business name
PURE CHIROPRACTIC & NATURAL HEALTH, PA
Practice address
200 Waymont CT
Suite 126, Unit #3
Lake Mary, FL 32746-3413
Phone
(407) 682-4454
Fax
(407) 682-3805
NPI assigned
Jan 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Authorized official

Name
Dr. Neal Wieder
Title
President
Phone
(407) 682-4454

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH3063 FL Primary
Independent Medical Examiner ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NI0013X CH3063 FL
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X CH3063 FL
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X CH3063 FL

Addresses

Primary practice location

200 Waymont CT
Suite 126, Unit #3
Lake Mary, FL 32746-3413

Mailing address

200 Waymont CT
Suite 126, Unit #3
Lake Mary, FL 32746-3413
Phone (407) 682-4454

Other identifiers 3

IdentifierTypeStateIssuer
1194299950OtherFLSTATE OF OHIO WORKER'S COMPENSATION
CH3063OtherFLSTATE OF FLORIDA WORKER'S COMPENSATION
88322AOtherFLBLUE CROSSS & BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

200 Waymont Ct
Ste 126
Lake Mary, FL 32746
Phone (407) 682-4454

NPI Registry JSON

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1780006403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WAYMONT CT",
            "address_2": "SUITE 126, UNIT #3",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463413",
            "telephone_number": "407-682-4454",
            "fax_number": "407-682-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WAYMONT CT",
            "address_2": "SUITE 126, UNIT #3",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463413",
            "telephone_number": "407-682-4454",
            "fax_number": "407-682-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE CHIROPRACTIC & NATURAL HEALTH, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "WIEDER",
        "authorized_official_first_name": "NEAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-682-4454",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH3063",
            "primary": true
        },
        {
            "code": "111NI0013X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "FL",
            "license": "CH3063",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": "FL",
            "license": "CH3063",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "CH3063",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OHIO WORKER'S COMPENSATION",
            "identifier": "1194299950",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA WORKER'S COMPENSATION",
            "identifier": "CH3063",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSSS & BLUE SHIELD",
            "identifier": "88322A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.