Midwest Wellness LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

MIDWEST WELLNESS LLC

Practice address

6822 E 82ND St Ste 310
Indianapolis, IN 46250-1677

Phone

(317) 548-4666

Fax

(317) 350-0059

NPI assigned

Aug 8, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Srinivasu Kesa, MD

Title

Owner

Phone

(317) 850-7725

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MD Medical Weightloss and Wellness Centers Doing business as

Tax ID family

MD Medical Weight Loss and Wellness Center2 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.

• Midwest Wellness LLC

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1497108468
  NPD tax ID

Locations

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

{
    "created_epoch": "1438992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438992000000",
    "number": "1306222757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6822 E 82ND ST STE 310",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462501677",
            "telephone_number": "317-548-4666",
            "fax_number": "317-350-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6822 E 82ND ST STE 310",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462501677",
            "telephone_number": "317-548-4666",
            "fax_number": "317-350-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-08",
        "last_updated": "2015-08-08",
        "status": "A",
        "authorized_official_last_name": "KESA",
        "authorized_official_first_name": "SRINIVASU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-850-7725",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200389120",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MD Medical Weightloss and Wellness Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Midwest Residential Services, Inc.
• Midwest Residential Services, Inc.
• Midwest Sleep Partners LLC
• Midwest Specialty Surgery Center, LLC
• Midwest Supervision and Evaluation
• Midwest Wellness LLC
• Midwesttaxi
• Theresa Miele, MA, LMHCA
• Tamara Lee Mielock, NP-C
• Catherine Elizabeth Faig Miers, MS, CGC

• Medical Specialty Clinic/Center in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Medical Specialty Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2015; 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.