NPIMap

Organization Active NPI

Powersmd Wellness Medical Group, Inc.

  • General Practice Physician
  • Huntington Beach, CA
National Provider Identifier
1265869820
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
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
Last updated
Sep 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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.NPI 1275846552
Title
President
Phone
(714) 903-4570

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0401X G15640 CA
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X G15640 CA Primary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X G15640 CA
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X G15640 CA

Addresses

Primary practice location

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

Mailing address

428 Main St
Suite 101
Huntington Beach, CA 92648-8142
Phone (714) 843-0400

National Provider Directory

National Provider Directory
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.

Practitioners & affiliated clinicians

Practitioners 1

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": "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • 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.