Wilson Wellness Group

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

5539340001 Issued in WI

Legal business name

WILSON WELLNESS GROUP

Doing business as

Bella Home Medical and Rehab

Practice address

4625 Sheridan Rd
Kenosha, WI 53140-3323

Phone

(262) 657-3333

Fax

(262) 657-6201

NPI assigned

Jun 3, 2006

Last updated

Jun 23, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Lawrence E Balkin

Title

President Ceo

Phone

(847) 217-1976

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bella Home Medical and Rehab Doing business as

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1649218215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 SHERIDAN RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531403323",
            "telephone_number": "262-657-3333",
            "fax_number": "262-657-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 SHERIDAN RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531403323",
            "telephone_number": "262-657-3333",
            "fax_number": "262-657-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON WELLNESS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "BALKIN",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "847-217-1976",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": "5539340001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417553300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bella Home Medical and Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracy E. Williams, CSAC
• Nathaniel Willkomm, LPC
• Daniel M. Willman, MS, LMFT, SAC-IT
• Tracy Willms, COTA
• Dale Wayne Willoughby, DDS
• Matthew William Winans, LAT
• Abigail Wincek
• Melissa A Wingate, PSYD
• Leslie Eugene Winget III
• Mackenzie Winkler, FNP

• Durable Medical Equipment & Medical Supplies in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.