Wellness Residential Services

Primary specialty

Home Health Clinical Nurse SpecialistTaxonomy code 364SH0200X

Legal business name

WELLNESS RESIDENTIAL SERVICES

Practice address

260 Northland Blvd Ste 216
Cincinnati, OH 45246-3651

Phone

(513) 969-4160

Fax

(513) 737-0018

NPI assigned

Nov 27, 2013

Organization subpart

Yes

Parent organization

WELLNESS RESIDENTIAL SERVICESAs reported in NPPES

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

Authorized official

Name

Mr. Idorenyin Udo Fred, STUDENT

Title

Director

Phone

(513) 969-4160

Specialties & licenses 1

Addresses

Part of

Wellness Residential Services

Locations

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1104256221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 NORTHLAND BLVD STE 216",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452463651",
            "telephone_number": "513-969-4160",
            "fax_number": "513-737-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 NORTHLAND BLVD STE 216",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452463651",
            "telephone_number": "513-969-4160",
            "fax_number": "513-737-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS RESIDENTIAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLNESS RESIDENTIAL SERVICES",
        "enumeration_date": "2013-11-27",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "FRED",
        "authorized_official_first_name": "IDORENYIN",
        "authorized_official_middle_name": "UDO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "513-969-4160",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "STUDENT"
    },
    "taxonomies": [
        {
            "code": "364SH0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Home Health",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Clinical Nurse Specialist in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Home Health Clinical Nurse Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.