Wellcare Labs, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

WELLCARE LABS, LLC

Practice address

1270 28TH St
Gulfport, MS 39501-6205

Phone

(228) 206-7355

Fax

(228) 284-5304

NPI assigned

Dec 5, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Anthony Bryan Smith

Title

Authorized Person

Phone

(228) 206-7355

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1225675531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 28TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395016205",
            "telephone_number": "228-206-7355",
            "fax_number": "228-284-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 28TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395016205",
            "telephone_number": "228-206-7355",
            "fax_number": "228-284-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE LABS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-05",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "AUTHORIZED PERSON",
        "authorized_official_telephone_number": "228-206-7355",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Champ Weeks, MD
• Destinie Chantal Weems, LPC
• Emily Hagin Weems
• Colton Anthony Wegrzyn, IDC
• Molly H Weir
• Wellness Within
• Jason Wells, CRNA
• Michaela Cheyenne Wells, NP-C
• Robert C Wessler, M.D
• Christen R Westbrook

• Clinical Medical Laboratory in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Clinical Medical Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.