NPIMap

Organization Active NPI

Wellnite Medical Group PA

  • Neurology Physician
  • Cleveland, OH
National Provider Identifier
1093443533
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
WELLNITE MEDICAL GROUP PA
Practice address
11811 Shaker Blvd Ste 204
Cleveland, OH 44120-1931
Phone
(341) 888-7637
NPI assigned
Aug 11, 2022
Last updated
Jun 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Authorized official

Name
Amy Halanski
Title
MD
Phone
(877) 644-6008

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

11811 Shaker Blvd Ste 204
Cleveland, OH 44120-1931

Mailing address

2261 Market St # 4058
San Francisco, CA 94114-1612
Phone (855) 731-1410

National Provider Directory

National Provider Directory
Tax ID family
Wellnite Medical Group PA47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

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

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1093443533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 MARKET ST # 4058",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141612",
            "telephone_number": "855-731-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11811 SHAKER BLVD STE 204",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201931",
            "telephone_number": "341-888-7637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNITE MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-11",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A",
        "authorized_official_last_name": "HALANSKI",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "877-644-6008"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.