NPIMap

Organization Active NPI

Envision Elite Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1104533603
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ENVISION ELITE WELLNESS
Practice address
50 Congress St Ste 636
Boston, MA 02109-4241
Phone
(617) 916-6212
NPI assigned
Nov 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Authorized official

Name
Jan Nelson, PMHNP-BCNPI 1134662893
Title
Owner
Phone
(781) 910-4598

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

50 Congress St Ste 636
Boston, MA 02109-4241

Mailing address

147 Jersey St
Marblehead, MA 01945-1346
Phone (781) 910-4598

Other names 1

  • Envision Elite Wellness Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL jan.nelson@envisionelitewellness.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1104533603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 JERSEY ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019451346",
            "telephone_number": "781-910-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CONGRESS ST STE 636",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021094241",
            "telephone_number": "617-916-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION ELITE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-910-4598",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jan.nelson@envisionelitewellness.com",
            "affiliation": "N",
            "endpointDescription": "email HIPAA compliant",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "50 Congress St Ste 636",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021094241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Envision Elite Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.