Wellness Integrative, PLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WELLNESS INTEGRATIVE, PLC

Practice address

1207 W 16TH St Ste B
Yuma, AZ 85364-4597

Phone

(928) 318-6310

Fax

(928) 328-1056

NPI assigned

Mar 31, 2016

Organization subpart

No

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

Authorized official

Name

Jennivyr Derakhshan

Title

Owner

Phone

(928) 318-6910

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David J Atondo, FNP

  • Family Nurse Practitioner
  • Yuma, AZ
  • NPI 1073954459
  NPD (past)
• Christal L Ott, FNP

  • Family Nurse Practitioner
  • Yuma, AZ
  • NPI 1831937465
  NPD (past)

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1619330388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 W 16TH ST STE B",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644597",
            "telephone_number": "928-318-6310",
            "fax_number": "928-328-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 W 16TH ST STE B",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644597",
            "telephone_number": "928-318-6310",
            "fax_number": "928-328-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS INTEGRATIVE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-31",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "DERAKHSHAN",
        "authorized_official_first_name": "JENNIVYR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-318-6910"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Weed Army Community Hospital (Yuma Proving Grounds Phcy)
• Michala Weick, PSYD
• William Weigt Jr., PHARMD
• Welbrook Yuma Opco LLC (Ridgeview Transitional Rehabilitation)
• Daniel W Welch
• West Genevieve Home Care
• Brandon Seville West, MD
• Sabrenia Renee West, MACCCSLP
• Werner Wester-Ebbinghaus, MD
• Western Arizona Council of Governments

• Family Medicine Physician in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; 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.