Community Wellness Clinic, LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

COMMUNITY WELLNESS CLINIC, LLC

Practice address

707 S Roland Rd Ste 6
Roland, OK 74954-5337

Phone

(479) 221-7119

NPI assigned

Nov 4, 2019

Last updated

Nov 4, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Noel Sanger

Title

Partner

Phone

(816) 769-1680

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572825600000",
    "number": "1154965044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 937",
            "city": "ROLAND",
            "state": "OK",
            "postal_code": "749540937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S ROLAND RD STE 6",
            "city": "ROLAND",
            "state": "OK",
            "postal_code": "749545337",
            "telephone_number": "479-221-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY WELLNESS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-04",
        "last_updated": "2019-11-04",
        "status": "A",
        "authorized_official_last_name": "SANGER",
        "authorized_official_first_name": "NOEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "816-769-1680"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine Physician in Roland, OK
• Providers in Roland, OK by specialty
• Pain Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.