New Body Weight Loss Center LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

NEW BODY WEIGHT LOSS CENTER LLC

Practice address

518 Washington St
Johnstown, PA 15901-2114

Phone

(954) 668-6938

NPI assigned

Jun 16, 2020

Organization subpart

No

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

Authorized official

Name

Kelly Modic

Title

Co Owner

Phone

(954) 668-6938

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1154946002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 VIRGINIA AVE",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159062431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 WASHINGTON ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159012114",
            "telephone_number": "954-668-6938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BODY WEIGHT LOSS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "MODIC",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "954-668-6938"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert D Nelson, MD
• Stephanie Nelson, MS
• Lana Nicole Ness, MSN, CRNP, FNP-C
• Daniel R Nevarre, MD
• David R Nevarre, PA-C
• New Dimension Dentistry
• New Dimension Dentistry & Orthodontics PC
• New Dimensions Dentistry and Orthodontics, P.C.
• Nicholas J. Masciotra MD PC
• Kelly Lynn Nicodemus

• Psychiatry Physician in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.