NPIMap

Organization Active NPI

Wellness Norwalk, Inc

Doing business as Medi-Weightloss Clinic of Wilton

  • Family Medicine Physician
  • Wilton, CT
National Provider Identifier
1487026332
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WELLNESS NORWALK, INC
Doing business as
Medi-Weightloss Clinic of Wilton
Practice address
70 Danbury Rd
Wilton, CT 06897-4408
Phone
(203) 349-6334
NPI assigned
Oct 29, 2015
Last updated
Oct 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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

Authorized official

Name
Peter B Daugavietis
Title
President
Phone
(646) 894-3881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X CT Primary

Addresses

Primary practice location

70 Danbury Rd
Wilton, CT 06897-4408

Mailing address

70 Danbury Rd
Wilton, CT 06897-4408
Phone (203) 349-6334

Other names 1

  • Medi-Weightloss Clinic of Wilton Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D2098993Wellness Norwalk, Inc70 Danbury Rd, Wilton, CT 06897Certificate of waiverJul 19, 2027

National Provider Directory

National Provider Directory

Locations

764 Washington Blvd
Stamford, CT 06901
Phone (203) 658-6556

70 Danbury Rd
Wilton, CT 06897
Phone (203) 349-6334

70 Danbury Rd
#1
Wilton, CT 06897

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446076800000",
    "number": "1487026332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 DANBURY RD",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068974408",
            "telephone_number": "203-349-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 DANBURY RD",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068974408",
            "telephone_number": "203-349-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS NORWALK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-29",
        "last_updated": "2015-10-29",
        "status": "A",
        "authorized_official_last_name": "DAUGAVIETIS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-894-3881"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medi-Weightloss Clinic of Wilton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.