Motion Wellness LLC
Organization Active NPI Chiropractor · Williston, FL
NPI 1992483010 · NPPES record last updated Jul 10, 2023
Key facts
- NPI
- 1992483010
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- MOTION WELLNESS LLC
- Practice address
- 510 SW 5TH Ter # B
Williston, FL 32696-2548 - Phone
- (352) 528-5433
- NPI assigned
- Jul 10, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. Richard J Fontaine III, DC
- Title
- Ceo/Owner
- Phone
- (401) 641-3421
Practitioners 2
-
Lacey Ebert, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230908000196 | FL | Part B Supplier - Clinic/Group Practice | 4789048836 |
Receives reassigned benefits from 2 practitioners Practice locations: Williston, FL |
National Provider Directory
Locations
510 SW 5th Ter
#B
Williston, FL 32696
Phone (352) 528-5433
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
510 SW 5TH Ter # B
Williston, FL 32696-2548
Mailing address
510 SW 5TH Ter # B
Williston, FL 32696-2548
Phone (352) 528-5433
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851660617 | Medicaid | FL |
Other providers in Williston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.