JMM Wellness, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

JMM WELLNESS, LLC

Practice address

1952 Whitney Ave
Hamden, CT 06517-1209

Phone

(203) 641-3574

NPI assigned

Jul 30, 2012

Organization subpart

No

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

Authorized official

Name

Jacqueline Mary McCullough, M.S., R.D., CD-NNPI 1356312771

Title

Registered Dietitian

Phone

(203) 641-3574

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Mary McCullough, MS RD CDN

  • Cardiovascular Disease Physician
  • Hamden, CT
  • NPI 1356312771
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343606400000",
    "number": "1023364981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 BUNKER HILL RD",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064371661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 WHITNEY AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065171209",
            "telephone_number": "203-641-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JMM WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-30",
        "last_updated": "2012-07-30",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "203-641-3574",
        "authorized_official_credential": "M.S., R.D., CD-N"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Athena M. Jenkins, LCSW/RN
• Jennifer C Vessicchio, LCSW LLC
• Jeralyn R. Fantarella, DMD, P.C.
• Kathleen D Jimmie, APRN
• JM Enterprises, LLC
• Johnson Homemaker & Companion With Care Agency
• Amy Susan Johnson, N.D.
• Ashley Victoria Johnson
• Crystal Lachea Johnson, MSN, PMHNP-BC
• Kelly Christine Johnson

• Registered Dietitian in Hamden, CT
• Providers in Hamden, CT by specialty
• Registered Dietitian in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.