Wellnessmd @ Acac LLC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

WELLNESSMD @ ACAC LLC

Practice address

406 Albemarle SQ
Charlottesville, VA 22901-1472

Phone

(434) 817-4280

Fax

(434) 817-4281

NPI assigned

Oct 3, 2007

Organization subpart

No

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

Authorized official

Name

Phil G Wendel

Title

Owner

Phone

(434) 974-9890

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1396932323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 ALBEMARLE SQUARE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229011472",
            "telephone_number": "434-817-4280",
            "fax_number": "434-817-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 ALBEMARLE SQ",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229011472",
            "telephone_number": "434-817-4280",
            "fax_number": "434-817-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESSMD @ ACAC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "WENDEL",
        "authorized_official_first_name": "PHIL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-974-9890"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL TPAN",
            "identifier": "00X553W38",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C10038",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen M Weldon, PA-C
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• Douglas Keith Wells Jr., MD
• Lynda T. Wells
• Thea Wells
• Welltower CCRC Opco LLC

• Sports Medicine (Family Medicine) Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Sports Medicine (Family Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.