NPIMap

Organization Active NPI

Wellness Medical Group LLC

  • Primary Care Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1609347301
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
WELLNESS MEDICAL GROUP LLC
Practice address
3017 W Charleston Blvd Ste 60
Las Vegas, NV 89102-1927
Phone
(702) 778-5100
Fax
(702) 778-5101
NPI assigned
Dec 7, 2018
Last updated
Aug 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Abegail Concon, APRNNPI 1053767335
Title
Aprn
Phone
(702) 778-5100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X
Primary Care Clinic/Center 261QP2300X Primary
Primary Care Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

3017 W Charleston Blvd Ste 60
Las Vegas, NV 89102-1927

Mailing address

3017 W Charleston Blvd Ste 60
Las Vegas, NV 89102-1927
Phone (702) 778-5100

National Provider Directory

National Provider Directory

Locations

3017 W Charleston Blvd
Ste 60
Las Vegas, NV 89102
Phone (702) 778-5100

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1544140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1609347301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 W CHARLESTON BLVD STE 60",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021927",
            "telephone_number": "702-778-5100",
            "fax_number": "702-778-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 W CHARLESTON BLVD STE 60",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021927",
            "telephone_number": "702-778-5100",
            "fax_number": "702-778-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-07",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "CONCON",
        "authorized_official_first_name": "ABEGAIL",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "702-778-5100",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.