Wellspring Weight & Wellness LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

WELLSPRING WEIGHT & WELLNESS LLC

Practice address

555 W Oak St Ste 1
Shelley, ID 83274-1161

Phone

(986) 249-7537

NPI assigned

Jul 8, 2024

Last updated

Jul 8, 2024By 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

Dr. Thomas M George Jr., DNP, FNP-CNPI 1417338930

Title

Clinical Director

Phone

(240) 308-1771

Specialties & licenses 1

Addresses

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.

• Thomas George Jr., DNP, CRNP, FNP-C

  • Family Nurse Practitioner
  • Shelley, ID
  • NPI 1417338930
  NPD Authorized official

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1043056260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W OAK ST STE 1",
            "city": "SHELLEY",
            "state": "ID",
            "postal_code": "832741161",
            "telephone_number": "986-249-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W OAK ST STE 1",
            "city": "SHELLEY",
            "state": "ID",
            "postal_code": "832741161",
            "telephone_number": "986-249-7537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING WEIGHT & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "240-308-1771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DNP, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie F. Sullivan, LMFT
• Corwin Sutherin
• Ty W. Swensen, PHARM.D.
• Rigoberto Vasquez
• Benjamin Waldron, DPT
• Jessica Kelley Westover
• Blaine L Wilding, PHARMD
• Travis R Wilkins, D.C.
• Brennan Todd Williams, D.C.
• Evelyn Williams, DPT

• Primary Care Nurse Practitioner in Shelley, ID
• Providers in Shelley, ID by specialty
• Primary Care Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.