New Smyrna Wellness Center – General Practice Physician, NPI 1992181077

New Smyrna Wellness Center is a healthcare provider. based in New smyrna beach, Florida. specializing in General Practice Physician. The NPI Number for New Smyrna Wellness Center is 1992181077

Main info

Organization
Name
New Smyrna Wellness Center
NPI
1992181077
Phone
(386) 957-1854
Address
502 PALMETTO ST
Authorized Official
MR. ELLIS FRANKLIN FORT III PHYSICIAN ASSISTANT P.A.
Enumeration Date
30 July 2015
Last Update Date
23 January 2026
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness90
Years active:10State licenses:0Digital endpoints

Provider Addresses for New Smyrna Wellness Center

  • 502 PALMETTO ST

    NEW SMYRNA BEACH, FL 321687325

    Phone: (386) 957-1854

    Fax: (386) 878-4967

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-01-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-02-29 (830 days ago).

Enrollment records

1

Earliest due date

2024-02-29

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20160119000856OClinic/Group PracticeFL2024-02-29

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32168)

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Reviews

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Frequently asked questions

What is the registry number for New Smyrna Wellness Center?
The registry entry for New Smyrna Wellness Center shows NPI 1992181077.
Should I treat New Smyrna Wellness Center as an active provider?
Patients and plans typically see New Smyrna Wellness Center as active in the national extract.
What services align with New Smyrna Wellness Center's listing?
New Smyrna Wellness Center's public classification highlights General Practice Physician. Clinical services aligned with this taxonomy classification.
What city is tied to New Smyrna Wellness Center?
The directory associates New Smyrna Wellness Center with New Smyrna Beach, Florida. Check all listed addresses for suites or satellite offices.
Can I export New Smyrna Wellness Center's record?
You can download the official NPPES record; we summarize key fields for readability.

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