Mygenetx Wellness, LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

MYGENETX WELLNESS, LLC

Practice address

525 W 5TH St Ste 310
Covington, KY 41011-1200

Phone

(513) 908-9447

NPI assigned

Feb 2, 2017

Organization subpart

No

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

Authorized official

Name

Larry Saunders

Title

President

Phone

(513) 908-9447

Specialties & licenses 1

Addresses

Other names 1

• Genetics4Health Doing business as

Locations

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485993600000",
    "number": "1154869774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 W 5TH ST STE 310",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410111200",
            "telephone_number": "513-908-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W 5TH ST STE 310",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410111200",
            "telephone_number": "513-908-9447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYGENETX WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-02-02",
        "status": "A",
        "authorized_official_last_name": "SAUNDERS",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-908-9447"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genetics4Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bonnie Jean Nicole Mullett, TCADC
• Cheryl Ann Mullins, CSW
• Kathleen Ann Mullins, CSR
• Diane Cousino Mushaben, LPCC
• Beth Ann Myers, MD
• Erin Michelle Nafus, MS, LPCC-S
• Nancy M Naiser, OPTICIAN
• Mallory Naylor, APRN
• Tomius R Neal, LCSW
• Mary Nebergall, LPCC

• Exclusive Provider Organization in Covington, KY
• Providers in Covington, KY by specialty
• Exclusive Provider Organization in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; 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.