Organization Active NPI

Wellness Walk-in Clinic, LLC

  • Family Nurse Practitioner
  • Florence, AL
National Provider Identifier
1235501891
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
WELLNESS WALK-IN CLINIC, LLC
Practice address
2612 Hough Road
Florence, AL 35630
Phone
(931) 629-0010
NPI assigned
Oct 22, 2015
Last updated
Oct 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Authorized official

Name
Ms. Victoria Park Cox, NPNPI 1902121577
Title
Nurse Practitioner/Owner
Phone
(931) 629-0010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AL Primary

Addresses

Primary practice location

2612 Hough Road
Florence, AL 35630

Mailing address

2612 Hough Road
Florence, AL 35630
Phone (931) 629-0010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160204002231 AL Part B Supplier - Clinic/Group Practice 5890099295 Receives reassigned benefits from 5 practitioners
Practice locations: Florence, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2107009Wellness Walk-in Clinic2612 Hough Road, Florence, AL 35630Certificate of waiverJan 4, 2028

National Provider Directory

National Provider Directory

Locations

2612 Hough Rd
Florence, AL 35630
Phone (256) 275-3724

Practitioners & affiliated clinicians

Practitioners 6

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": "1445472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445472000000",
    "number": "1235501891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2612 HOUGH ROAD",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "35630",
            "telephone_number": "931-629-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2612 HOUGH ROAD",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "35630",
            "telephone_number": "931-629-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS WALK-IN CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-22",
        "last_updated": "2015-10-22",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "PARK",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "931-629-0010",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.