Active NPI
MW Wellness VIII, LLC
- Family Medicine Physician
- Enfield, CT
National Provider Identifier
1639695935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MW WELLNESS VIII, LLC
- Practice address
- 155 Hazard Ave Ste 2
Enfield, CT 06082 - Phone
- (813) 228-6763
- NPI assigned
- Aug 17, 2017
- Last updated
- Jun 26, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jodi Despoy
- Title
- Manager
- Phone
- (813) 228-6334
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | Primary |
Addresses
Primary practice location
155 Hazard Ave Ste 2
Enfield, CT 06082
Mailing address
155 Hazard Ave Ste 2
Enfield, CT 06082-4586
Phone (813) 228-6763
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 07D2151575 | MW Wellness VIII, LLC | Certificate of waiver | Jul 22, 2028 |
National Provider Directory
National Provider DirectoryLocations
155 Hazard Ave
Ste 2
Enfield, CT 06082
Phone (860) 698-6041
Practitioners & affiliated clinicians
Practitioners 10
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.
-
- Physician Assistant
- Enfield, CT
- NPI 1780108167
-
- Physician Assistant
- Enfield, CT
- NPI 1194387431
-
- Family Nurse Practitioner
- Enfield, CT
- NPI 1073356705
-
- Nurse Practitioner
- Enfield, CT
- NPI 1134869092
-
- Adult Health Nurse Practitioner
- Enfield, CT
- NPI 1497092928
-
- Physician Assistant
- Enfield, CT
- NPI 1881295913
-
- Gerontology Nurse Practitioner
- Manchester, CT
- NPI 1508024894
-
- Medical Physician Assistant
- Hartford, CT
- NPI 1750797973
-
- Physician Assistant
- West Springfield, MA
- NPI 1639731011
-
- Family Nurse Practitioner
- Boston, MA
- NPI 1366023566
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502928000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1687737600000",
"number": "1639695935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 HAZARD AVE STE 2",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060824586",
"telephone_number": "813-228-6763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 HAZARD AVE STE 2",
"city": "ENFIELD",
"state": "CT",
"postal_code": "06082",
"telephone_number": "813-228-6763"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MW WELLNESS VIII, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-08-17",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A",
"authorized_official_last_name": "DESPOY",
"authorized_official_first_name": "JODI",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "813-228-6334"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Enfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.