Wellness Fundamentals Inc.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

WELLNESS FUNDAMENTALS INC.

Practice address

100 Alcott PL Apt 4K
Bronx, NY 10475-4153

Phone

(917) 346-1806

NPI assigned

Jun 10, 2021

Organization subpart

No

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

Authorized official

Name

Lorraine Jaysura, NP

Title

Officer

Phone

(917) 346-1806

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1396312948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 651",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104750651",
            "telephone_number": "917-346-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ALCOTT PL APT 4K",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104754153",
            "telephone_number": "917-346-1806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1469 Astor Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104695846",
            "country_code": "US",
            "telephone_number": "917-346-1806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLNESS FUNDAMENTALS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "JAYSURA",
        "authorized_official_first_name": "LORRAINE",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "917-346-1806",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa G Wellington, PA
• Tameika L Wellington, RN
• Winifred Wellington, LPN
• Tahira Atiyah Wellman, M.S., PA-C
• Wellness Drugs Corp
• Wellness Market (The Wellness Plug)
• Wellness Medical Assoc., P.C.
• Wellness Medical Supply Corp.
• Wellness Physical Therapy PC
• Wellness Registered Nursing, P.C.

• Family Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.