Welllife Primary Care

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

136549 Issued in NC

Legal business name

WELLLIFE PRIMARY CARE

Practice address

211 E Six Forks Rd
Suite 122
Raleigh, NC 27609-7745

Phone

(919) 829-1315

NPI assigned

Jul 19, 2012

Organization subpart

No

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

Authorized official

Name

Dwan Kelsey, NP

Title

Owner

Phone

(919) 829-1315

Specialties & licenses 1

Addresses

Tax ID family

Welllife Primary Care2 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.

• Welllife Primary Care

  • Adult Health Nurse Practitioner
  • Raleigh, NC
  • NPI 1336401058
  NPD tax ID

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342656000000",
    "number": "1316292907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E. SIX FORKS RD",
            "address_2": "SUITE 122",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27609",
            "telephone_number": "919-829-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E SIX FORKS RD",
            "address_2": "SUITE 122",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097745",
            "telephone_number": "919-829-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLLIFE PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-19",
        "status": "A",
        "authorized_official_last_name": "KELSEY",
        "authorized_official_first_name": "DWAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-829-1315",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "136549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Kirkland Wellborn, MD
• Wellcare Health Insurance of North Carolina, Inc
• Abigail Weller, BSN, RNC-OB
• Wellington Provider Group PC
• Welllife House Calls
• Welllife Primary Care
• Welllife:a Diabetes Clinic and Educational Resource Center
• Danielle Lemuth Wellman, MD
• Wellness & Transport Services, LLC
• Wellness Associates PLLC

• Primary Care Clinic/Center in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.