Organization Active NPI

Wellnet360 Health

  • Family Medicine Physician
  • Tulare, CA
National Provider Identifier
1124977764
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WELLNET360 HEALTH
Practice address
1559 Hillman St
Tulare, CA 93274-1633
Phone
(833) 221-4169
NPI assigned
Jan 27, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Authorized official

Name
Okiemute Charles Odeghe,NPI 1376062638
Title
President
Phone
(855) 250-8003

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1559 Hillman St
Tulare, CA 93274-1633

Mailing address

2023 E Prosperity Ave # 55
Tulare, CA 93274-7756
Phone (855) 250-8003

Other names 1

  • WellNet360 Virtual Urgent Care Medical Corp. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260304002717 CA Part B Supplier - Clinic/Group Practice 1759863293 Receives reassigned benefits from 1 practitioner
Practice locations: Tulare, CA

National Provider Directory

National Provider Directory

Locations

2023 E Prosperity Ave
Tulare, CA 93274

1559 Hillman St
Tulare, CA 93274
Phone (805) 415-0178

Practitioners & affiliated clinicians

Practitioners 2

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": "1769472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772755200000",
    "number": "1124977764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 E PROSPERITY AVE # 55",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932747756",
            "telephone_number": "855-250-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1559 HILLMAN ST",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932741633",
            "telephone_number": "833-221-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNET360 HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A",
        "authorized_official_last_name": "ODEGHE,",
        "authorized_official_first_name": "OKIEMUTE",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "855-250-8003"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellNet360 Virtual Urgent Care Medical Corp.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulare, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; 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.