ADVANCED SPINE AND WELLNESS — NPI 1154736866 (Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) in WINTER HAVEN, FL)

CMS-1500 Box 24J / 33a • NPI

1154736866

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

111NN0400X (CMS 35)

Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist)

Box 32 Service Location & ZIP+4

1125 1ST ST S, WINTER HAVEN, FL, 33880-3902

✓ 9-Digit EDI 837 ZIP+4 (33880-3902)

Practice Phone & Referral Fax

(863) 293-0040

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1154736866 (ADVANCED SPINE AND WELLNESS) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1154736866` (NPI-2 Organization / Facility)
Provider / Legal Name	ADVANCED SPINE AND WELLNESS
Plain-English Specialty	Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) NUCC Code: `111NN0400X` (Chiropractor, Neurology)
Certifying / Licensing Body	American Board of Psychiatry and Neurology (ABPN)
Practice Location Address	1125 1ST ST S, WINTER HAVEN, FL, 33880-3902
Practice Telephone / Fax	Tel: (863) 293-0040
Administrative Mailing Address	1125 1ST ST S, WINTER HAVEN, FL, 33880-3902
Enumeration & Last Sync	Enumerated: 2014-06-23 \| CMS Record Updated: 2014-06-23
Authorized Official	CLARK LEMMON (President)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1125 1ST ST S, WINTER HAVEN, FL, 33880-3902

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Plain-English Taxonomy & CMS Crosswalk (111NN0400X)

What Does Taxonomy Code 111NN0400X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 111NN0400X translates to:
"Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 35 (Chiropractic)
Certifying / Accrediting Authority: American Board of Psychiatry and Neurology (ABPN)
Clinical Scope: Stroke recovery, chronic or severe migraines, seizures, numbness/tingling in hands or feet (neuropathy), tremors, memory loss, or suspected CSF leak.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ADVANCED SPINE AND WELLNESS)

Typical CPT / Diagnostic Procedures:

Electroencephalography (EEG — CPT 95816) for Seizure & Epilepsy Evaluation
Electromyography (EMG) & Nerve Conduction Studies (NCS)
Lumbar Puncture & Cerebrospinal Fluid (CSF) Pressure/Analysis
Acute Ischemic Stroke NIHSS Assessment & Neuroimaging Review

Common Therapeutic Classes:

CGRP Antagonists & Triptans (Sumatriptan, Rizatriptan) for Migraine
Antiepileptic Drugs (Levetiracetam, Lamotrigine, Valproate)
Levodopa/Carbidopa (Parkinson's Disease) & Gabapentin/Pregabalin (Neuropathy)
Antiplatelet & Secondary Stroke Prevention Regimens

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`111NN0400X` — Chiropractor, Neurology Plain English: Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist)	State: FL \| License: `Ch9923` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ADVANCED SPINE AND WELLNESS (NPI #1154736866)