MD Weight Loss and Wellness, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

MD WEIGHT LOSS AND WELLNESS, LLC

Practice address

3416 Old Greenwood Road
Fort Smith, AR 72903

Phone

(479) 242-2888

Fax

(479) 242-2889

NPI assigned

Apr 20, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Sarah Coluccino

Title

Office Manager

Phone

(479) 242-2888

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524182400000",
    "number": "1316434707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3416 OLD GREENWOOD ROAD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72903",
            "telephone_number": "479-242-2888",
            "fax_number": "479-242-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3416 OLD GREENWOOD ROAD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72903",
            "telephone_number": "479-242-2888",
            "fax_number": "479-242-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD WEIGHT LOSS AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-20",
        "last_updated": "2018-04-20",
        "status": "A",
        "authorized_official_last_name": "COLUCCINO",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "479-242-2888",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "AR",
            "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 Apr 20, 2018; 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.