Advanced Clinical & Orthopedic Massage Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA29117 Issued in FL

Legal business name

ADVANCED CLINICAL & ORTHOPEDIC MASSAGE INC

Doing business as

The Injury Care Center

Practice address

2930 Okeechobee Blvd
Suite 108
West Palm Beach, FL 33409-4037

Phone

(561) 684-1169

Fax

(561) 684-6112

NPI assigned

Nov 1, 2006

Last updated

Jun 16, 2008By 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

Mr. Simon W Briscoe, LMT, NCMMT

Title

President/Ceo

Phone

(561) 684-1169

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Injury Care Center Doing business as

Locations

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1871670778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 GOLDENWOOD WAY",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144966",
            "telephone_number": "561-798-3564",
            "fax_number": "561-798-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 OKEECHOBEE BLVD",
            "address_2": "SUITE 108",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334094037",
            "telephone_number": "561-684-1169",
            "fax_number": "561-684-6112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CLINICAL & ORTHOPEDIC MASSAGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "BRISCOE",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "561-684-1169",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMT, NCMMT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA29117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA ID #",
            "identifier": "C4052",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Injury Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.