NPIMap

Organization Active NPI

Wellness Stamford, Inc.

  • Family Medicine Physician
  • Stamford, CT
National Provider Identifier
1083198196
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WELLNESS STAMFORD, INC.
Practice address
75 Tresser Blvd
Stamford, CT 06901-3329
Phone
(646) 894-3881
NPI assigned
Sep 24, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Authorized official

Name
Peter Daugavietis
Title
Owner
Phone
(646) 894-3881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

75 Tresser Blvd
Stamford, CT 06901-3329

Mailing address

70 Danbury Rd
Wilton, CT 06897-4408

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537747200000",
    "number": "1083198196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 DANBURY RD",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068974408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 TRESSER BLVD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069013329",
            "telephone_number": "646-894-3881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS STAMFORD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-09-24",
        "status": "A",
        "authorized_official_last_name": "DAUGAVIETIS",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-894-3881"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.