Organization Active NPI

Dr S Weightloss & Wellness, PLLC

  • Internal Medicine Physician
  • Greenville, NC
National Provider Identifier
1306484795
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DR S WEIGHTLOSS & WELLNESS, PLLC
Practice address
202 E Arlington Blvd Ste D
Greenville, NC 27858-5021
Phone
(252) 227-0080
NPI assigned
Dec 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Authorized official

Name
Nachida Hamidi, MDNPI 1215107156
Title
Physician
Phone
(252) 227-0080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

202 E Arlington Blvd Ste D
Greenville, NC 27858-5021

Mailing address

1704 Rondo Dr
Greenville, NC 27858-5339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200416002168 NC Part B Supplier - Clinic/Group Practice 6406286301 Receives reassigned benefits from 1 practitioner
Practice locations: Greenville, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2174584Dr S Weightloss and Wellness, PLLC202 E Arlington Boulevard, Suite D, Greenville, NC 27858Certificate of waiverNov 4, 2027

National Provider Directory

National Provider Directory

Locations

202 E Arlington Blvd
Ste D
Greenville, NC 27858
Phone (252) 227-0080

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1306484795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 RONDO DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E ARLINGTON BLVD STE D",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585021",
            "telephone_number": "252-227-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR S WEIGHTLOSS & WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "HAMIDI",
        "authorized_official_first_name": "NACHIDA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "252-227-0080",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.