NPIMap

Organization Active NPI

Dynamic Pain & Wellness LLC

  • Specialist
  • Crestview, FL
National Provider Identifier
1861963290
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DYNAMIC PAIN & WELLNESS LLC
Practice address
210 S Main St
Crestview, FL 32536-3737
Phone
(850) 226-6801
Fax
(877) 413-5104
NPI assigned
Dec 11, 2018
Organization subpart
Yes
Parent organization
DYNAMIC PAIN & WELLNESS PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Authorized official

Name
Sarah Bailey
Title
Credentialing
Phone
(850) 226-6801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

210 S Main St
Crestview, FL 32536-3737

Mailing address

210 S Main St
Crestview, FL 32536-3737
Phone (850) 226-6801

National Provider Directory

National Provider Directory
Tax ID family
Dynamic Pain Wellness LLC8 organizations share this tax ID, including this one
Part of
Dynamic Pain Wellness LLC

Other organizations with this tax ID 7

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1544486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777593600000",
    "number": "1861963290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S MAIN ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325363737",
            "telephone_number": "850-226-6801",
            "fax_number": "877-413-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S MAIN ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325363737",
            "telephone_number": "850-226-6801",
            "fax_number": "877-413-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PAIN & WELLNESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DYNAMIC PAIN & WELLNESS PLLC",
        "enumeration_date": "2018-12-11",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "850-226-6801"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; 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.