Powersmd Wellness Medical Group, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G15640 Issued in CA

Legal business name

POWERSMD WELLNESS MEDICAL GROUP, INC.

Practice address

6552 Bolsa Ave
Suite H
Huntington Beach, CA 92647-2660

Phone

(714) 903-4570

Fax

(714) 903-4571

NPI assigned

Sep 27, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Thomas S. Powers, M.D.

Title

President

Phone

(714) 903-4570

Specialties & licenses 4

Addresses

Other identifiers 1

Tax ID family

Powersmd Wellness Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Powersmd Wellness Medical Group

  • General Practice Physician
  • Huntington Beach, CA
  • NPI 1740612134
  NPD tax ID

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1265869820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 MAIN ST",
            "address_2": "SUITE 101",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926488142",
            "telephone_number": "714-843-0400",
            "fax_number": "714-969-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6552 BOLSA AVE",
            "address_2": "SUITE H",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926472660",
            "telephone_number": "714-903-4570",
            "fax_number": "714-903-4571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWERSMD WELLNESS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "POWERS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-903-4570",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "CA",
            "license": "G15640",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "G15640",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "G15640",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "G15640",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G15640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mia Ellen Powell, R.N.F.A.
• Thomas Raymond Power, D.C.
• Joseph Thomas Powers, PPSC, PPSSW, CWA
• Thomas Shelton Powers, M.D.
• Powersmd Wellness Medical Group
• Gayle M. Poynter, L.C.S.W.
• Angeline Pozzi
• Premier Surgery Center, LLC
• Eric C Preszler, P.T.
• Catelyn Tayler Price, OD

• General Practice Physician in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.