Organization Active NPI

Integrative Wellness, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1649043845
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
INTEGRATIVE WELLNESS, LLC
Practice address
1821 Highway 39 N Ste K
Meridian, MS 39301-2725
Phone
(601) 627-0257
Fax
(601) 258-4682
NPI assigned
Oct 31, 2023
Last updated
Nov 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Authorized official

Name
Comanechi Clayton, PMHNP-BCNPI 1790303816
Title
Owner
Phone
(601) 627-0257

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

1821 Highway 39 N Ste K
Meridian, MS 39301-2725

Mailing address

1821 Highway 39 N Ste K
Meridian, MS 39301-2725
Phone (601) 627-0257

National Provider Directory

National Provider Directory

Locations

1821 Highway 39 N
Ste K
Meridian, MS 39301
Phone (601) 627-0257

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": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1649043845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 HIGHWAY 39 N STE K",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393012725",
            "telephone_number": "601-627-0257",
            "fax_number": "601-258-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 HIGHWAY 39 N STE K",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393012725",
            "telephone_number": "601-627-0257",
            "fax_number": "601-258-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "COMANECHI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-627-0257",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.