Stravada Wellness Care LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

STRAVADA WELLNESS CARE LLC

Practice address

203 Broad St Unit C-4
Milford, CT 06460-4750

Phone

(413) 218-9839

NPI assigned

Oct 25, 2020

Last updated

Oct 25, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maria Koursaris, DNPNPI 1164083879

Title

Aprn

Phone

(413) 218-9839

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maria Christina Koursaris, APRN

  • Adult Health Nurse Practitioner
  • Guilford, CT
  • NPI 1164083879
  NPD Authorized official

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

{
    "created_epoch": "1603584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603584000000",
    "number": "1114526688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 SEASIDE AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064604602",
            "telephone_number": "413-218-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 BROAD ST UNIT C-4",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064604750",
            "telephone_number": "413-218-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRAVADA WELLNESS CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-25",
        "last_updated": "2020-10-25",
        "certification_date": "2020-10-25",
        "status": "A",
        "authorized_official_last_name": "KOURSARIS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "413-218-9839",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Milford, CT
• Providers in Milford, CT by specialty
• Multi-Specialty Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; 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.