Wellington Manor, LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

WELLINGTON MANOR, LLC

Practice address

375 Hendrick Drive
Newport, TN 37821-5344

Phone

(863) 226-0358

NPI assigned

Mar 15, 2019

Organization subpart

No

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

Authorized official

Name

Janis K Stovall, DO

Title

Director of Operations

Phone

(386) 478-6759

Specialties & licenses 1

Addresses

Other names 1

• Louis Garrard - Mainstay Senior Living Former legal business name

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

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1154880557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 LAKE MORTON DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015344",
            "telephone_number": "863-226-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 HENDRICK DRIVE",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378215344",
            "telephone_number": "863-226-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLINGTON MANOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-15",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "STOVALL",
        "authorized_official_first_name": "JANIS",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "386-478-6759",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Louis Garrard - Mainstay Senior Living",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jonathan Lewis Weathersby, MA
• Brandi Webb, LPN
• Deborah Diane Webb, LPN
• Stefanie Dawn Webb, RN BSN
• Robert Allen Welch, PHARM.D.
• Brooke Lashea Wells, LPN
• Christel Moates Westmorland, DDS
• Micah L Westmorland, D.D.S.
• Thomas Whitmer
• Katie Wick, NP-C

• Assisted Living Facility (Mental Illness) in Newport, TN
• Providers in Newport, TN by specialty
• Assisted Living Facility (Mental Illness) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.