NPIMap

Organization Active NPI

MW Wellness Ventures IV LLC

  • Family Medicine Physician
  • Dartmouth, MA
National Provider Identifier
1194308494
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MW WELLNESS VENTURES IV LLC
Practice address
370 Faunce Corner Rd
Dartmouth, MA 02747-1271
Phone
(813) 228-6334
NPI assigned
May 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Authorized official

Name
Stacey Heald
Title
Manager
Phone
(813) 228-6334

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Obesity Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QB0002X

Addresses

Primary practice location

370 Faunce Corner Rd
Dartmouth, MA 02747-1271

Mailing address

509 S Hyde Park Ave
Tampa, FL 33606-2266
Phone (813) 228-6334

National Provider Directory

National Provider Directory

Locations

370 Faunce Corner Rd
Ste 1SE
Dartmouth, MA 02747

370 Faunce Corner Rd
Ste 1
North Dartmouth, MA 02747

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1194308494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 S HYDE PARK AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062266",
            "telephone_number": "813-228-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 FAUNCE CORNER RD",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027471271",
            "telephone_number": "813-228-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MW WELLNESS VENTURES IV LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "HEALD",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "813-228-6334"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dartmouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.