NPIMap

Organization Active NPI

New Horizons Wellness Center

  • Primary Care Clinic/Center
  • Enterprise, AL
National Provider Identifier
1184621120
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
DO463 Issued in AL
Legal business name
NEW HORIZONS WELLNESS CENTER
Practice address
1018 Rucker Blvd Ste a
Enterprise, AL 36330-3688
Phone
(334) 347-4343
Fax
(334) 393-9611
NPI assigned
Jul 6, 2005
Last updated
Mar 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Authorized official

Name
Dr. Mark B Ellis, D.O.NPI 1083632244
Title
Physician
Phone
(334) 347-4343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X DO463 AL Primary

Addresses

Primary practice location

1018 Rucker Blvd Ste a
Enterprise, AL 36330-3688

Mailing address

300 N Edwards St
Enterprise, AL 36330-2508
Phone (334) 347-4343

Other identifiers 1

IdentifierTypeStateIssuer
529918990MedicaidAL

National Provider Directory

National Provider Directory

Locations

1018 Rucker Blvd
Ste A
Enterprise, AL 36330
Phone (334) 347-4343

300 N Edwards St
Enterprise, AL 36330
Phone (334) 347-4343

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1184621120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N EDWARDS ST",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302508",
            "telephone_number": "334-347-4343",
            "fax_number": "334-393-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 RUCKER BLVD STE A",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363303688",
            "telephone_number": "334-347-4343",
            "fax_number": "334-393-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HORIZONS WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-06",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "334-347-4343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AL",
            "license": "DO463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529918990",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.