South Lake Wellness & Injury Center, PL

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH0007823 Issued in FL

Legal business name

SOUTH LAKE WELLNESS & INJURY CENTER, PL

Practice address

2745 Citrus Tower Blvd
Clermont, FL 34711-6699

Phone

(352) 241-4111

Fax

(352) 241-4113

NPI assigned

Feb 6, 2008

Last updated

May 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Mary Beth Brockman

Title

Billing Manager

Phone

(352) 241-4111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 4

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.

• Peter Joseph Brockman, D.C.

  • Chiropractor
  • Clermont, FL
  • NPI 1518067503
  Medicare reassignment Care Compare group NPD
• Michael Callahan, DC

  • Chiropractor
  • Clermont, FL
  • NPI 1003408576
  Medicare reassignment Care Compare group NPD
• Matthew Joseph Uhrik, D.C., M.S., M.S.

  • Chiropractor
  • Fruitland Park, FL
  • NPI 1194267278
  Medicare reassignment Care Compare group
• David E Turner, D.O.M.

  • Acupuncturist
  • Clermont, FL
  • NPI 1285863068
  NPD (past)

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1851579320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 CITRUS TOWER BLVD",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116699",
            "telephone_number": "352-241-4111",
            "fax_number": "352-241-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 CITRUS TOWER BLVD",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116699",
            "telephone_number": "352-241-4111",
            "fax_number": "352-241-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LAKE WELLNESS & INJURY CENTER, PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "BROCKMAN",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "352-241-4111",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0007823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Lake Medicine P a
• South Lake Obstetrics & Gynecology, LLC (South Lake OB/GYN and Advanced Surgery)
• South Lake Pain Institute, Inc
• South Lake Pediatrics, P.a.
• South Lake Primary Care P a
• Southlake Autism and Behavior Services, PA
• Sarah Michelle Spangler
• Yumika Sparkman, MSW, LCSW
• Kristin Spear
• Welty Alina Spears, RN

• Chiropractor in Clermont, FL
• Providers in Clermont, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.