NPIMap

Organization Active NPI

Palm Beach Wellness Center LLC

  • Primary Care Clinic/Center
  • Lake Worth, FL
National Provider Identifier
1932415635
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
8817 Issued in FL
Legal business name
PALM BEACH WELLNESS CENTER LLC
Practice address
6169 S Jog Rd
Suite B3
Lake Worth, FL 33467-6579
Phone
(561) 433-9191
Fax
(561) 433-4404
NPI assigned
Aug 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Authorized official

Name
Chad Durnan
Title
Managing Member
Phone
(561) 433-9191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 8817 FL Primary

Addresses

Primary practice location

6169 S Jog Rd
Suite B3
Lake Worth, FL 33467-6579

Mailing address

6169 S Jog Rd
Suite B3
Lake Worth, FL 33467-6579
Phone (561) 433-9191

National Provider Directory

National Provider Directory

Locations

6169 S Jog Rd
Ste B3
Lake Worth, FL 33467
Phone (561) 433-9191

7130 S Military Trl
Lake Worth, FL 33463
Phone (561) 429-3793

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1932415635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6169 S JOG RD",
            "address_2": "SUITE B3",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676579",
            "telephone_number": "561-433-9191",
            "fax_number": "561-433-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6169 S JOG RD",
            "address_2": "SUITE B3",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676579",
            "telephone_number": "561-433-9191",
            "fax_number": "561-433-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-19",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "DURNAN",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "561-433-9191"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "8817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.