Wellcare, LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

082334 Issued in AZ

Legal business name

WELLCARE, LLC

Practice address

18275 N 59TH Ave Ste 138
Glendale, AZ 85308-1253

Phone

(602) 564-0078

Fax

(602) 564-1154

NPI assigned

Jul 16, 2006

Organization subpart

No

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

Authorized official

Name

Derek Sebade, ANP-C

Title

Owner

Phone

(602) 564-0078

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366469140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVE STE 138",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081253",
            "telephone_number": "602-564-0078",
            "fax_number": "602-564-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVE STE 138",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081253",
            "telephone_number": "602-564-0078",
            "fax_number": "602-564-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SEBADE",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-564-0078",
        "authorized_official_credential": "ANP-C"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "082334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61944",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chanie Weiss
• Laureen Weiss, R.N.
• Michelle Weissgerber
• Aeshli Laree Weldert
• Emily Welker, M.D.
• Katharina Wells, LMFT, LPCC, RN
• Teresa Wells
• Wen Zhong, PLLC
• Laura Marie Wendlandt, PH.D.
• Elaina M Wendt

• All providers in Glendale, AZ
• Primary Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.