Wynter Wellness Group LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

WYNTER WELLNESS GROUP LLC

Practice address

1017 S Fairhill St
Philadelphia, PA 19147-4007

Phone

(215) 690-1336

Fax

(215) 392-3462

NPI assigned

Dec 6, 2021

Organization subpart

No

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

Authorized official

Name

Alexandria Wynter RussellNPI 1669803664

Title

Owner/Provider

Phone

(917) 579-6305

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alexandria Russell

  • Speech-Language Pathologist
  • Philadelphia, PA
  • NPI 1669803664
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1396403408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 S FAIRHILL ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191474007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 S FAIRHILL ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191474007",
            "telephone_number": "215-690-1336",
            "fax_number": "215-392-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNTER WELLNESS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-06",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "ALEXANDRIA",
        "authorized_official_middle_name": "WYNTER",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "917-579-6305"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Wynne, MA, CCC-SLP
• Megan Wynne, MD
• Michael Wynne
• Shakeera Wynne
• Sanelia Wynter Corrodus, FNP-C
• Sophia Monica Wynter-Evans, CRNA
• Wynters Compassionate Garden Home Care Agency LLC
• Leslie Wynveen
• Wyoming Chiropractic Center Inc
• Wyoming Pharmacy LLC (Wyoming Pharmacy)

• Speech-Language Pathologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.