Collaborative Care & Wellness LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

COLLABORATIVE CARE & WELLNESS LLC

Practice address

8028 Ritchie Hwy Ste 104
Pasadena, MD 21122-1020

Phone

(410) 245-0210

NPI assigned

Mar 21, 2023

Last updated

Aug 9, 2023By 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

Mrs. Shirley Pack, FNPNPI 1619567906

Title

Owner

Phone

(410) 245-0210

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shirley Lin Pack, NURSE PRACTITIONER

  • Nurse Practitioner
  • Odenton, MD
  • NPI 1619567906
  Authorized official Same address or phone

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1164124269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SUMMERTIME DR",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211131590",
            "telephone_number": "410-245-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8028 RITCHIE HWY STE 104",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211221020",
            "telephone_number": "410-245-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE CARE & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-08-09",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "PACK",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-245-0210",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Koreena Clark
• Naja Sekai Clarke
• Colleen Clements, LAC, CH
• Samantha Mikael Cobb, LCPC
• Ross Samuel Cohen, D.P.M.
• Martavius Collins, OTR/L
• Rachel Collins
• Communication Connections Inc
• Danielle Elisa Cook
• Courtney Lynn Cooley, PT

• Family Nurse Practitioner in Pasadena, MD
• Providers in Pasadena, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.