Revive Chiropractic & Med Spa, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH8257 Issued in FL

Legal business name

REVIVE CHIROPRACTIC & MED SPA, LLC

Practice address

494 W Hillsboro Blvd
Deerfield Beach, FL 33441-1604

Phone

(561) 715-7956

NPI assigned

Aug 21, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Mark Richards, D.C.

Title

President

Phone

(561) 715-7956

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443744000000",
    "number": "1831566165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "494 W HILLSBORO BLVD",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411604",
            "telephone_number": "561-715-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "494 W HILLSBORO BLVD",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411604",
            "telephone_number": "561-715-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE CHIROPRACTIC & MED SPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-21",
        "last_updated": "2015-10-02",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-715-7956",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; 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.