360 Wellness Solutions, LLC

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Legal business name

360 WELLNESS SOLUTIONS, LLC

Practice address

194 Loch Lomond Rd
Rancho Mirage, CA 92270-5600

Phone

(760) 832-8025

Fax

(760) 764-4010

NPI assigned

Jul 18, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Katherine Josephine Sullivan, PHD, PTNPI 1285033878

Title

President

Phone

(760) 832-8025

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• 360 Wellness Solutions Mobile and Telehealth Services Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

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

• Katherine Josephine Sullivan, PT

  • Neurology Physical Therapist
  • Rancho Mirage, CA
  • NPI 1285033878
  Medicare reassignment Authorized official
• Belita Paulette Williams, RN

  • Registered Nurse
  • Cathedral City, CA
  • NPI 1154072551

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1447773825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 LOCH LOMOND RD",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922705600",
            "telephone_number": "760-832-8025",
            "fax_number": "760-764-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 LOCH LOMOND RD",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922705600",
            "telephone_number": "760-832-8025",
            "fax_number": "760-764-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 WELLNESS SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-18",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "JOSEPHINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-832-8025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, PT"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1447773825",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CASH",
            "identifier": "1285033878",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@360wellnesssolutions.net",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Rancho Mirage",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "194 Loch Lomond Rd",
            "city": "Rancho Mirage",
            "state": "CA",
            "country_code": "US",
            "postal_code": "922705600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "360 Wellness Solutions Mobile and Telehealth Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Benedict Carillo Abaya, FNP-BC, FNP-C
• Mehrdad Abbasi, MD

• Case Manager/Care Coordinator in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.