Elite Wellness Waco LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

ELITE WELLNESS WACO LLC

Doing business as

Elite Wellness Massage and Aesthetics

Practice address

1217 S Hewitt Dr
Hewitt, TX 76643-3200

Phone

(254) 723-2400

NPI assigned

Feb 21, 2025

Last updated

Feb 21, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marquis Mangrum, LMTNPI 1295427979

Title

Founder

Phone

(254) 723-2400

Specialties & licenses 1

Addresses

Other names 1

• Elite Wellness Massage and Aesthetics Doing business as

Locations

Practitioners 1

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.

• Marquis Mangrum

  • Massage Therapist
  • Hewitt, TX
  • NPI 1295427979

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1518763499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 S HEWITT DR",
            "city": "HEWITT",
            "state": "TX",
            "postal_code": "766433200",
            "telephone_number": "254-723-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 S HEWITT DR",
            "city": "HEWITT",
            "state": "TX",
            "postal_code": "766433200",
            "telephone_number": "254-723-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE WELLNESS WACO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "MANGRUM",
        "authorized_official_first_name": "MARQUIS",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "254-723-2400",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Wellness Massage and Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tonya Nichole Davis, BCBA-D
• Jon Braden Debault, APRN-CNP
• DJF Enterprise, PLLC (Brazos Homecare Medical Services / Brazos Medical Clinic)
• Nancy Dominguez, EDD, MED, LPC
• Parker James Donner, PH.D.
• Mark Anthony Ervi, M.S.S.W., LCSW
• Lori Espinosa, PHARMD
• Melissa Farmer, RBT
• Aimee Lyn Farris
• Firstlight Home Care of Waco

• Massage Therapist in Hewitt, TX
• Providers in Hewitt, TX by specialty
• Massage Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.