NPIMap

Organization Active NPI

Well Infused, LLC

Doing business as Well Infused

  • Nurse Practitioner
  • Noblesville, IN
National Provider Identifier
1477204550
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
WELL INFUSED, LLC
Doing business as
Well Infused
Practice address
14297 Bergen Blvd Ste 125
Noblesville, IN 46060-3420
Phone
(317) 674-8857
NPI assigned
Jan 11, 2022
Organization subpart
Yes
Parent organization
LEGACY IMPACT HOLDINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Authorized official

Name
Dr. Staci J Blume, DCNPI 1033375662
Title
Owner / Partner
Phone
(317) 674-8857

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

14297 Bergen Blvd Ste 125
Noblesville, IN 46060-3420

Mailing address

14297 Bergen Blvd Ste 125
Noblesville, IN 46060-3420
Phone (317) 674-8857

Other names 1

  • Well Infused Doing business as

National Provider Directory

National Provider Directory

Locations

14297 Bergen Blvd
Ste 125
Noblesville, IN 46060
Phone (317) 674-8857

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1477204550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14297 BERGEN BLVD STE 125",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460603420",
            "telephone_number": "317-674-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14297 BERGEN BLVD STE 125",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460603420",
            "telephone_number": "317-674-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL INFUSED, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEGACY IMPACT HOLDINGS, LLC",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "BLUME",
        "authorized_official_first_name": "STACI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER / PARTNER",
        "authorized_official_telephone_number": "317-674-8857",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Well Infused",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Noblesville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.