Wellness Ambulatory Care Inc.
Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Memphis, TN
NPI 1316539109 · NPPES record last updated Dec 23, 2024
Key facts
- NPI
- 1316539109
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
- Legal business name
- WELLNESS AMBULATORY CARE INC.
- Practice address
- 4539 Winchester Rd Ste 111
Memphis, TN 38118-5100 - Phone
- (901) 372-7878
- Fax
- (901) 373-9298
- NPI assigned
- Feb 3, 2021
- Organization subpart
- No
Authorized official
- Name
- Jay Higham
- Title
- Ceo
- Phone
- (214) 365-6112
Other NPIs on the same Medicare enrollment 13
Corporate family (same tax ID) 12
Practitioners 21
-
Brian Edward Fuller, M.D.
-
Jennifer Hicks, DNP, APRN, FNP-BC
-
Lisa Anne Hill, APN
-
Parul V Patel, MSN,FNP-BC
-
Jessica N Brown, NP
-
Nicky Edwards, APN
-
Jessica Grace Folger, M.D.
-
Emily Aldridge Hahn, M.D.
-
William A. James, M.D.
-
Seth I Kaufman, MD
-
Molly Ledbetter, FNP
-
Jo-Ann S. Marrs, NURSE PRACTITIONER
-
Lisa Torres, NP-C, PMHNP-C
-
Raza Hussain, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2223217 | Wellness Ambulatory Care Inc | Certificate of waiver | May 4, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210120000765 | TN | Part B Supplier - Clinic/Group Practice | 2163703901 |
Receives reassigned benefits from 29 practitioners 13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Savannah, TN; Paris, TN; Nashville, TN; Murfreesboro, TN; Memphis, TN; Knoxville, TN; Jackson, TN; Dyersburg, TN… |
National Provider Directory
- Tax ID family
- Wellness Ambulatory Care Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | Yes |
Addresses
Primary practice location
4539 Winchester Rd Ste 111
Memphis, TN 38118-5100
Mailing address
5001 Spring Valley Road
Suite 600 East
Dallas, TX 75244
Phone (214) 365-6100
Other names
- BHG Medical Services Memphis South
Other providers in Memphis, TN
- Wellcare, LLC
- Robert Weller
- Wellgraph Gen Corp
- Wellgraph Gen Corp
- Wellness Ambulatory Care Inc.
- Wellness Ambulatory Care Inc.
- Wellness Evaluation Services, Inc
- Wellness First Inc
- Wellness One Memphis PC
- Christopher Louis Wells
All providers in Memphis, TN · Substance Use Disorder Rehabilitation Clinic/Center in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.