Integrated Wellness Clinic PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INTEGRATED WELLNESS CLINIC PC

Practice address

491 Allendale Rd Ste 222
King of Prussia, PA 19406-1431

Phone

(610) 265-0500

Fax

(610) 265-0502

NPI assigned

Feb 3, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Andre Garabedian, MD

Title

Owner

Phone

(610) 265-0500

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1437741295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 ALLENDALE RD STE 222",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061431",
            "telephone_number": "610-265-0500",
            "fax_number": "610-265-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 ALLENDALE RD STE 222",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061431",
            "telephone_number": "610-265-0500",
            "fax_number": "610-265-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED WELLNESS CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "GARABEDIAN",
        "authorized_official_first_name": "JOSEPH ANDRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-265-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972758464",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154433316",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.