Organization Active NPI

Wellness Dimensions LLC

  • Internal Medicine Physician
  • Naples, FL
National Provider Identifier
1588908834
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME105338 Issued in FL
Legal business name
WELLNESS DIMENSIONS LLC
Practice address
400 8TH St N # 2
Naples, FL 34102-5519
Phone
(239) 649-3306
Fax
(239) 649-3393
NPI assigned
Nov 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

Name
Kavitha GudurNPI 1194888479
Title
MGR
Phone
(305) 487-8140

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X ME105338 FL Primary

Addresses

Primary practice location

400 8TH St N # 2
Naples, FL 34102-5519

Mailing address

400 8TH St N # 2
Naples, FL 34102-5519
Phone (239) 649-3306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130429000302 FL Part B Supplier - Clinic/Group Practice 1850537382 Receives reassigned benefits from 7 practitioners
Practice locations: Naples, FL

National Provider Directory

National Provider Directory

Locations

400 8th St N
#2
Naples, FL 34102
Phone (239) 649-3306

8795 Tamiami Trl E
Ste 201
Naples, FL 34113
Phone (239) 403-0060

400 8th St N
Ste 2
Naples, FL 34102
Phone (239) 649-3306

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1588908834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 8TH ST N # 2",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025519",
            "telephone_number": "239-649-3306",
            "fax_number": "239-649-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 8TH ST N # 2",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025519",
            "telephone_number": "239-649-3306",
            "fax_number": "239-649-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS DIMENSIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-26",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "GUDUR",
        "authorized_official_first_name": "KAVITHA",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "305-487-8140"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME105338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.