Organization Active NPI

Metropolitan Wellness Specialists, LLC

  • Cardiovascular Disease Physician
  • Washington, DC
National Provider Identifier
1083998074
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD33157 Issued in DC
Legal business name
METROPOLITAN WELLNESS SPECIALISTS, LLC
Practice address
1120 19TH St NW
Suite 316
Washington, DC 20036-3605
Phone
(202) 499-6999
NPI assigned
Oct 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Authorized official

Name
Roquell Wyche
Title
Solo Proprietor
Phone
(202) 812-4933

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RB0002X MD33157 DC
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X MD33157 DC Primary

Addresses

Primary practice location

1120 19TH St NW
Suite 316
Washington, DC 20036-3605

Mailing address

1015 I St NE
Washington, DC 20002-3747
Phone (202) 499-6999

Other identifiers 1

IdentifierTypeStateIssuer
040147900MedicaidDC

National Provider Directory

National Provider Directory

Locations

1120 19th St NW
Ste 316
Washington, DC 20036
Phone (202) 466-3570

Practitioners & affiliated clinicians

Practitioners 2

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": "1318032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1083998074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 I ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200023747",
            "telephone_number": "202-499-6999",
            "fax_number": "202-331-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 19TH ST NW",
            "address_2": "SUITE 316",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200363605",
            "telephone_number": "202-499-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN WELLNESS SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-08",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "WYCHE",
        "authorized_official_first_name": "ROQUELL",
        "authorized_official_title_or_position": "SOLO PROPRIETOR",
        "authorized_official_telephone_number": "202-812-4933"
    },
    "taxonomies": [
        {
            "code": "207RB0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "DC",
            "license": "MD33157",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "DC",
            "license": "MD33157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040147900",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.