The Wellness Center

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

AC7529 Issued in CA

Legal business name

THE WELLNESS CENTER

Practice address

625 F St Ste a
Crescent City, CA 95531-3732

Phone

(707) 487-4444

NPI assigned

Aug 22, 2015

Last updated

Aug 22, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Jody L Mangum, MSOM, D.AC., L.AC.NPI 1548387616

Title

Owner

Phone

(707) 487-4444

Specialties & licenses 1

Addresses

Tax ID family

The Wellness Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Wellness Center

  • Acupuncturist
  • Smith River, CA
  • NPI 1669852968
  NPD tax ID

Locations

Practitioners 1

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.

• Jody L Mangum, LAC

  • Acupuncturist
  • Crescent City, CA
  • NPI 1548387616
  NPD (past) Authorized official

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

{
    "created_epoch": "1440201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440201600000",
    "number": "1013384312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 9TH ST",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955313433",
            "telephone_number": "707-487-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 F ST STE A",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955313732",
            "telephone_number": "707-487-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-22",
        "last_updated": "2015-08-22",
        "status": "A",
        "authorized_official_last_name": "MANGUM",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-487-4444",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSOM, D.AC., L.AC."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "AC7529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Zenon Tamayo
• Erica Tarens
• Collin Michael Taylor, PT
• Anna Tellechea, BA
• Amber Marie Terhune, SBD
• Laurie Lee Thomas, PAC
• Kathryn Thompson
• Thrifty Payless Inc (Rite Aid Pharmacy 06040)
• Catherine Ann Tietjen, L.M.F.T., R.N.
• Douglas Tippman, LMFT

• Medical Specialty Clinic/Center in Crescent City, CA
• Providers in Crescent City, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.