Wellington Provider Group PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WELLINGTON PROVIDER GROUP PC

Practice address

1000 N West St Ste 1200
Wilmington, DE 19801-1058

Phone

(859) 518-8817

Fax

(859) 201-1084

NPI assigned

Dec 19, 2022

Last updated

Dec 19, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

WELLINGTON PROVIDER GROUP PCAs reported in NPPES

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

Authorized official

Name

Mariela Bravo

Title

Credentialing Team Lead

Phone

(859) 518-8817

Specialties & licenses 1

Addresses

Part of

Wellington Provider Group P

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1629780804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 WELLINGTON WAY STE 330",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031331",
            "telephone_number": "859-518-8817",
            "fax_number": "859-201-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N WEST ST STE 1200",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198011058",
            "telephone_number": "859-518-8817",
            "fax_number": "859-201-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLINGTON PROVIDER GROUP PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLINGTON PROVIDER GROUP PC",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "BRAVO",
        "authorized_official_first_name": "MARIELA",
        "authorized_official_title_or_position": "CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "859-518-8817"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gyliane Weisenfeld
• Cherie Weiss, PH.D.
• Stephanie Weiss
• Mari E. Welch, APN
• Rebecca Welcher, DO
• Genesis Unique Wellington
• Wellness Medical Care LLC
• Wellness Medical LLC (Kennedy Health Center)
• Wellnite Medical Group PA
• Adar Wells

• Family Medicine Physician in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Family Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.