Health & Wellness Family Practice Service PC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

197679 Issued in NY

Legal business name

HEALTH & WELLNESS FAMILY PRACTICE SERVICE PC

Practice address

11481 177TH PL
Jamaica, NY 11434-1405

Phone

(718) 658-6767

Fax

(718) 206-0861

NPI assigned

Apr 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Sonia Evadne Walker-Adamson, D.ONPI 1184789778

Title

Owner/President

Phone

(718) 658-6767

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

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

• Sonia Evadne Walker-Adamson, D.O.

  • Family Medicine Physician
  • St. Albans, NY
  • NPI 1184789778
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1306019765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11481 177TH PL",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341405",
            "telephone_number": "718-658-6767",
            "fax_number": "718-206-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11481 177TH PL",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341405",
            "telephone_number": "718-658-6767",
            "fax_number": "718-206-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH & WELLNESS FAMILY PRACTICE SERVICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "WALKER-ADAMSON",
        "authorized_official_first_name": "SONIA",
        "authorized_official_middle_name": "EVADNE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "718-658-6767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "197679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01580318",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.