NPIMap

Organization Active NPI

Inner Balance Family Medicine, LLC

  • Family Medicine Physician
  • Port St. Lucie, FL
National Provider Identifier
1851729693
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME106391 Issued in FL
Legal business name
INNER BALANCE FAMILY MEDICINE, LLC
Practice address
1801 SE Hillmoor Drive
Suite C-106
Port St. Lucie, FL 34952-7551
Phone
(772) 249-0636
Fax
(772) 237-3114
NPI assigned
Oct 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Authorized official

Name
Dr. Dionne Layne Hinds, DONPI 1154593184
Title
Owner
Phone
(772) 249-0636

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME106391 FL Primary

Addresses

Primary practice location

1801 SE Hillmoor Drive
Suite C-106
Port St. Lucie, FL 34952-7551

Mailing address

1801 SE Hillmoor Drive
Suite C-106
Port St. Lucie, FL 34952-7551
Phone (772) 249-0636

Other names 1

  • Inner Balance Family Medicine, PA Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131119000750 FL Part B Supplier - Clinic/Group Practice 6305072455 Receives reassigned benefits from 1 practitioner
Practice locations: Port St Lucie, FL

National Provider Directory

National Provider Directory
Tax ID family
Inner Balance3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1801 SE Hillmoor Dr
Ste C-106
Port St Lucie, FL 34952
Phone (561) 649-0877

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1381708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1851729693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DRIVE",
            "address_2": "SUITE C-106",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "349527551",
            "telephone_number": "772-249-0636",
            "fax_number": "772-237-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DRIVE",
            "address_2": "SUITE C-106",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "349527551",
            "telephone_number": "772-249-0636",
            "fax_number": "772-237-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER BALANCE FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-14",
        "last_updated": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "HINDS",
        "authorized_official_first_name": "DIONNE",
        "authorized_official_middle_name": "LAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-249-0636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME106391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inner Balance Family Medicine, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Port St. Lucie, FL

Sources for this page

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