Organization Active NPI

Premier Wellness Centers of Stuart LLC

  • Chiropractor
  • Stuart, FL
National Provider Identifier
1902218183
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10127 Issued in FL
Legal business name
PREMIER WELLNESS CENTERS OF STUART LLC
Practice address
2155 SE Federal Hwy
Stuart, FL 34994-4514
Phone
(772) 201-0500
Fax
(772) 201-0501
NPI assigned
May 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Authorized official

Name
Dr. William J Jensen, DC
Title
Chiropractor
Phone
(772) 879-8700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH10127 FL Primary

Addresses

Primary practice location

2155 SE Federal Hwy
Stuart, FL 34994-4514

Mailing address

10050 SW Innovation Way
Suite 201
Port St Lucie, FL 34987-2117
Phone (772) 879-8700

National Provider Directory

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": "1400716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1902218183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10050 SW INNOVATION WAY",
            "address_2": "SUITE 201",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872117",
            "telephone_number": "772-879-8700",
            "fax_number": "772-879-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944514",
            "telephone_number": "772-201-0500",
            "fax_number": "772-201-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER WELLNESS CENTERS OF STUART LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-22",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "772-879-8700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.