Reconnect Wellness Pascagoula LLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

RECONNECT WELLNESS PASCAGOULA LLC

Practice address

4211 Hospital St Ste 114
Pascagoula, MS 39581-5320

Phone

(662) 680-3148

NPI assigned

May 10, 2018

Organization subpart

No

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

Authorized official

Name

Douglas M Wright

Title

Managing Member

Phone

(662) 680-3148

Specialties & licenses 1

Addresses

Other names 1

• Reconnect Therapy and Wellness Doing business as

Locations

Practitioners 1

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

• Rebecca Hedegaard

  • Speech-Language Pathologist
  • Pascagoula, MS
  • NPI 1407333602
  NPD (past)

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1033609581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2844 TRACELAND DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014200",
            "telephone_number": "662-680-3148",
            "fax_number": "662-620-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 HOSPITAL ST STE 114",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815320",
            "telephone_number": "662-680-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECONNECT WELLNESS PASCAGOULA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-10",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "662-680-3148"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reconnect Therapy and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hugo A Quintana, MD
• R. Kent Ozon MD PLLC
• Leslie Ramon
• Randy S Kirksey Marriage and Family Therapist
• Pamela Rawdon, LCSW
• Ashley Reed
• Holly Anne Reeves, LPC
• Regional Digestive Specialists P.C.
• Rachel Valera Reves, MFT, LPC
• Kyla Austin Richburg, NP

• Preferred Provider Organization in Pascagoula, MS
• Providers in Pascagoula, MS by specialty
• Preferred Provider Organization in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.