NPIMap

Organization Active NPI

Wellness by Physicians, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Wildwood, FL
National Provider Identifier
1093167603
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
WELLNESS BY PHYSICIANS, INC.
Doing business as
physicians rehabilitation
Practice address
4076 E Sr 44
Wildwood, FL 34785-7486
Phone
(239) 768-6396
NPI assigned
Jul 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
George Ghanem
Title
Coo
Phone
(239) 768-6396

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

4076 E Sr 44
Wildwood, FL 34785-7486

Mailing address

6150 Diamond Centre CT.
BLDG 100
Fort Myers, FL 33912
Phone (239) 768-6396

Other names 1

  • physicians rehabilitation Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161103002581 FL DME Supplier - Physician - General Practice 4688966260 Practice locations: Wildwood, FL

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Wellness by Physicians Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

137 S Pebble Beach Blvd
Ste 204
Sun City Center, FL 33573
Phone (267) 255-5137

NPI Registry JSON

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1093167603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 DIAMOND CENTRE CT.",
            "address_2": "BLDG 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33912",
            "telephone_number": "239-768-6396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 E SR 44",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347857486",
            "telephone_number": "239-768-6396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS BY PHYSICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-07",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "GHANEM",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "239-768-6396"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "physicians rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "physicians rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wildwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.