Wellness Boutique LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

22891 Issued in SC

Legal business name

WELLNESS BOUTIQUE LLC

Practice address

107 W College Ave
Hartsville, SC 29550-4113

Phone

(843) 861-2726

NPI assigned

Aug 14, 2012

Organization subpart

No

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

Authorized official

Name

McHelle S Quaye, MD

Title

Medical Director

Phone

(843) 861-2726

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1497002901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1763",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295511763",
            "telephone_number": "843-861-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W COLLEGE AVE",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504113",
            "telephone_number": "843-861-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS BOUTIQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-14",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "QUAYE",
        "authorized_official_first_name": "MCHELLE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "843-861-2726",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "22891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28916",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• We Care of South Carolina LLC
• We the Forerunners
• Liston Alexander Weatherly Jr., APRN
• Amanda Jo Webb, PA-C
• Angela Wellman
• Jesse Michael West, PH.D
• Harold Neil Wheeler, M.D.
• Brandy Hulsey White, MCD CCC-SLP
• Vedia Goodson White, RN
• Brianna Wilds, BS

• Obstetrics & Gynecology Physician in Hartsville, SC
• Providers in Hartsville, SC by specialty
• Obstetrics & Gynecology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.