Ascend Polywellness Center, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

ASCEND POLYWELLNESS CENTER, LLC

Practice address

7630 Little River Tpke Ste 305
Annandale, VA 22003-2610

Phone

(678) 507-4370

NPI assigned

Jan 11, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Anong Clement Ncho, PA-CNPI 1346543212

Title

Ceo

Phone

(678) 507-4370

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anong Clement Ncho, PA-C

  • Physician Assistant
  • Morrow, GA
  • NPI 1346543212

  DC

  Medicare reassignment Authorized official
• Maureen A Ohene

  • Psychiatric/Mental Health Nurse Practitioner
  • Triangle, VA
  • NPI 1003512781

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1736553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1295545226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 CAMELOT DR",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220031306",
            "telephone_number": "678-507-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7630 LITTLE RIVER TPKE STE 305",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032610",
            "telephone_number": "678-507-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCEND POLYWELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-11",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A",
        "authorized_official_last_name": "NCHO",
        "authorized_official_first_name": "ANONG",
        "authorized_official_middle_name": "CLEMENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-507-4370",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Annandale, VA
• Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.