Wellness Clinic, P.C.

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

MD000025744 Issued in TN

Legal business name

WELLNESS CLINIC, P.C.

Practice address

5740 Getwell Rd
BLDG 4C
Southaven, MS 38672-6346

Phone

(662) 892-5000

Fax

(662) 892-5002

NPI assigned

Apr 17, 2007

Last updated

Feb 15, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Savira V Sidhu, M.D.NPI 1184796203

Title

President

Phone

(662) 892-5000

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Savira Virk Sidhu, MD

  • Psychiatry Physician
  • Southaven, MS
  • NPI 1184796203
  Authorized official Same address or phone
• Ross E Collins Jr., M.D.

  • Child & Adolescent Psychiatry Physician
  • Tupelo, MS
  • NPI 1508893074
  NPD (past)
• Melissa M Sisco, LPC

  • Professional Counselor
  • Southaven, MS
  • NPI 1700830122
  NPD (past)
• Laurie Alice Miller, APRN, BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Memphis, TN
  • NPI 1063693893
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297728000000",
    "number": "1386860898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2024",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386542209",
            "telephone_number": "662-892-5000",
            "fax_number": "662-892-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5740 GETWELL RD",
            "address_2": "BLDG 4C",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386726346",
            "telephone_number": "662-892-5000",
            "fax_number": "662-892-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2011-02-15",
        "status": "A",
        "authorized_official_last_name": "SIDHU",
        "authorized_official_first_name": "SAVIRA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-892-5000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "TN",
            "license": "MD000025744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00120361",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3725205",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F95674",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Watson, DO
• Callie Claire Watts, CCC-SLP
• Beverly P. Weaver, RN, MSN, FNP-BC
• Dawn Webb, FNP
• William Jacob Weller, M.D.
• Chelcey Rennee Wells
• Kenji Jermaine Wells
• Willie Johnathan Wells, LPC
• Robert James Wenzler, DPM
• Michael L Wertheimer, MD

• Prescribing (Medical) Psychologist in Southaven, MS
• Providers in Southaven, MS by specialty
• Prescribing (Medical) Psychologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.