Active NPI
Preventative Wellness Solutions II, PLLC
- Family Medicine Physician
- Winston Salem, NC
National Provider Identifier
1376296152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- PREVENTATIVE WELLNESS SOLUTIONS II, PLLC
- Practice address
- 3878 Oxford Station Way
Winston Salem, NC 27103-1340 - Phone
- (813) 228-6334
- NPI assigned
- Feb 1, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John Kaloust
- Title
- Manager
- Phone
- (813) 228-6334
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Obesity Medicine (Family Medicine) Physician | 207QB0002X |
Addresses
Primary practice location
3878 Oxford Station Way
Winston Salem, NC 27103-1340
Mailing address
509 S Hyde Park Ave
Tampa, FL 33606-2266
Phone (813) 228-6334
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2253596 | Preventative Wellness Solutions II PLLC | Certificate of waiver | Feb 22, 2028 |
National Provider Directory
National Provider DirectoryLocations
3878 Oxford Station Way
Winston Salem, NC 27103
Phone (336) 306-5900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643673600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1672876800000",
"number": "1376296152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 S HYDE PARK AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336062266",
"telephone_number": "813-228-6334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3878 OXFORD STATION WAY",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031340",
"telephone_number": "813-228-6334"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREVENTATIVE WELLNESS SOLUTIONS II, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-02-01",
"last_updated": "2023-01-05",
"certification_date": "2023-01-05",
"status": "A",
"authorized_official_last_name": "KALOUST",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "813-228-6334"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207QB0002X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Obesity Medicine",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.