Active NPI
Oakland Park Wellness Center
- Family Nurse Practitioner
- Oakland Park, FL
National Provider Identifier
1811529530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- OAKLAND PARK WELLNESS CENTER
- Practice address
- 3857 Powerline Rd
Oakland Park, FL 33309-5067 - Phone
- (954) 635-2900
- NPI assigned
- Feb 11, 2020
- 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
- Kimberly Kodzik, APRN
- Title
- Co-Owner
- Phone
- (954) 309-5736
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
3857 Powerline Rd
Oakland Park, FL 33309-5067
Mailing address
3857 Powerline Rd
Oakland Park, FL 33309-5067
Phone (954) 635-2900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073654281 | Medicaid | FL | |
| 1316344484 | Medicaid | FL |
National Provider Directory
National Provider DirectoryLocations
3857 Powerline Rd
Oakland Park, FL 33309
Phone (954) 635-2900
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Deerfield Beach, FL
- NPI 1073654281
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581379200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1581379200000",
"number": "1811529530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3857 POWERLINE RD",
"city": "OAKLAND PARK",
"state": "FL",
"postal_code": "333095067",
"telephone_number": "954-635-2900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3857 POWERLINE RD",
"city": "OAKLAND PARK",
"state": "FL",
"postal_code": "333095067",
"telephone_number": "954-635-2900"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OAKLAND PARK WELLNESS CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2020-02-11",
"last_updated": "2020-02-11",
"certification_date": "2020-02-11",
"status": "A",
"authorized_official_last_name": "KODZIK",
"authorized_official_first_name": "KIMBERLY",
"authorized_official_title_or_position": "CO-OWNER",
"authorized_official_telephone_number": "954-309-5736",
"authorized_official_credential": "APRN"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1073654281",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1316344484",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakland Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.