The Transformation Doctor, LLC Dba Wellnessmd

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

THE TRANSFORMATION DOCTOR, LLC DBA WELLNESSMD

Practice address

3680 S Houston Levee Rd Ste 104
Collierville, TN 38017-9151

Phone

(901) 221-7212

Fax

(901) 221-7217

NPI assigned

Nov 13, 2019

Last updated

Jul 7, 2020By 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

Allison White

Title

Clinic Owner/Administrator

Phone

(901) 221-7212

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Interoperability endpoints

• Direct secure messaging: info@wellnessmd.clinic

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594080000000",
    "number": "1225673395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3680 S HOUSTON LEVEE RD STE 104",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380179151",
            "telephone_number": "901-221-7212",
            "fax_number": "901-221-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 S HOUSTON LEVEE RD STE 104",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380179151",
            "telephone_number": "901-221-7212",
            "fax_number": "901-221-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE TRANSFORMATION DOCTOR, LLC DBA WELLNESSMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-13",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "CLINIC OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "901-221-7212"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@wellnessmd.clinic",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3680 S Houston Levee Rd Ste 104",
            "city": "Collierville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "380179151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinic/Center in Collierville, TN
• Providers in Collierville, TN by specialty
• Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.