Upscale Enterprises 2 Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

UPSCALE ENTERPRISES 2 INC

Doing business as

Revive Family Chiropractic

Practice address

13300 S Cleveland Ave Ste 27
Fort Myers, FL 33907-3877

Phone

(239) 288-5748

NPI assigned

Feb 5, 2021

Organization subpart

No

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

Authorized official

Name

Dr. David Nguyen, DCNPI 1922699628

Title

Owner

Phone

(239) 288-5748

Specialties & licenses 1

Addresses

Other names 1

• Revive Family Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Nguyen, DC

  • Chiropractor
  • Fort Myers, FL
  • NPI 1922699628
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1790377364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13300 S CLEVELAND AVE STE 27",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13300 S CLEVELAND AVE STE 27",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073877",
            "telephone_number": "239-288-5748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSCALE ENTERPRISES 2 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-288-5748",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.