Wholeness Medical Services LLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

31090 Issued in CO

Legal business name

WHOLENESS MEDICAL SERVICES LLC

Practice address

2620 E Prospect Rd Ste 190
Fort Collins, CO 80525-9098

Phone

(970) 221-1106

Fax

(970) 232-1050

NPI assigned

Sep 20, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Scott Shannon, M.D.

Title

Owner/Member

Phone

(970) 221-1106

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316476800000",
    "number": "1073896700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 E PROSPECT RD STE 190",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259098",
            "telephone_number": "970-221-1106",
            "fax_number": "970-232-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 E PROSPECT RD STE 190",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259098",
            "telephone_number": "970-221-1106",
            "fax_number": "970-232-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLENESS MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "970-221-1106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "31090",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "31090",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "31090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.