Natural Wellness Clinics, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

NATURAL WELLNESS CLINICS, LLC

Practice address

3000 Fern Valley Rd
Louisville, KY 40213-3522

Phone

(904) 563-0332

NPI assigned

Dec 3, 2019

Organization subpart

No

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

Authorized official

Name

Tommie Douglas Benefield Jr., LHC

Title

Founding Partner/Owner

Phone

(904) 563-0332

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1306483979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 PLAINFIELD AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733923",
            "telephone_number": "904-563-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 FERN VALLEY RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402133522",
            "telephone_number": "904-563-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATURAL WELLNESS CLINICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-03",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "BENEFIELD",
        "authorized_official_first_name": "TOMMIE",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "FOUNDING PARTNER/OWNER",
        "authorized_official_telephone_number": "904-563-0332",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.