Wheeler Clinic Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

WHEELER CLINIC INC

Practice address

855 Lakewood Rd
Waterbury, CT 06704-5408

Phone

(860) 793-3500

NPI assigned

May 16, 2019

Last updated

Sep 11, 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

Athena Szczesniak

Title

Chief Financial Officer

Phone

(860) 793-4235

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265098180. Details of each certification follow.

• CCN 071946 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 071946

Legal name

WHEELER CLINIC INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Nov 19, 2019

Last certification

Nov 19, 2019

Ownership / control type

For profit – corporation

Organization structure

OtherNon-profit

Incorporated

Jan 8, 1968 in CT

Enrollment address

855 Lakewood Rd
Waterbury, CT 67045408

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Wheeler Clinic Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Plainville, CT
  • NPI 1396750840

  0345147153

  Same PAC ID
• Wheeler Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Bristol, CT
  • NPI 1790532802

  0345147153

  Same PAC ID
• Wheeler Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Plainville, CT
  • NPI 1871108076

  0345147153

  Same PAC ID
• Wheeler Clinic Inc.

  • Federally Qualified Health Center (FQHC)
  • Bristol, CT
  • NPI 1164987301

  0345147153

  Same PAC ID
• Wheeler Clinic Inc.

  • Federally Qualified Health Center (FQHC)
  • New Britain, CT
  • NPI 1285203612

  0345147153

  Same PAC ID
• Wheeler Clinic Inc.

  • Federally Qualified Health Center (FQHC)
  • Hartford, CT
  • NPI 1518467174

  0345147153

  Same PAC ID
• Wheeler Clinic Inc.

  • Federally Qualified Health Center (FQHC)
  • Bristol, CT
  • NPI 1548760119

  0345147153

  Same PAC ID

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1265098180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 NORTHWEST DR",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621534",
            "telephone_number": "860-793-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 LAKEWOOD RD",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067045408",
            "telephone_number": "860-793-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHEELER CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-16",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "SZCZESNIAK",
        "authorized_official_first_name": "ATHENA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "860-793-4235"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah R West
• Eric Westry, ED.M., M.S., M.A.
• Westside Medical Group
• Robert Satterlee Wetmore, M.D.
• Sarah Michelle Whalen, APRN
• Sheila Wheelock, BSW
• Ellen Whelan
• Andrea L White
• Darryl White, MS,PT
• Karla White, BA

• Federally Qualified Health Center (FQHC) in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Federally Qualified Health Center (FQHC) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.