NPIMap

Organization Active NPI

Wellness Networks, Inc

  • Family Medicine Physician
  • Highland Park, MI
National Provider Identifier
1154712271
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WELLNESS NETWORKS, INC
Practice address
64 Victor St
Highland Park, MI 48203-3128
Phone
(313) 446-9800
Fax
(313) 446-9839
NPI assigned
Feb 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Authorized official

Name
Tanya Mauldin
Title
Provider Enrollment Manger
Phone
(414) 225-1611

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Clinic/Center 261Q00000X
Health Service Clinic/Center 261QH0100X

Addresses

Primary practice location

64 Victor St
Highland Park, MI 48203-3128

Mailing address

Dept CH 14583
Palatine, IL 60055-0001
Phone (866) 525-5484

Other names 1

  • AIDS Partnership Michigan Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251009001652 MI Part B Supplier - Clinic/Group Practice 4587161013 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: Highland Park, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
AIDS Partnership Michigan Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

64 Victor St
Highland Park, MI 48203
Phone (313) 446-9800

Practitioners & affiliated clinicians

Practitioners 5

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": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774396800000",
    "number": "1154712271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT CH 14583",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600550001",
            "telephone_number": "866-525-5484",
            "fax_number": "833-394-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 VICTOR ST",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482033128",
            "telephone_number": "313-446-9800",
            "fax_number": "313-446-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS NETWORKS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A",
        "authorized_official_last_name": "MAULDIN",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT MANGER",
        "authorized_official_telephone_number": "414-225-1611"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AIDS Partnership Michigan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Highland Park, MI

Sources for this page

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