Moco Wellness

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

MOCO WELLNESS

Practice address

6517 Persimmon Tree Rd
Cabin John, MD 20818-1216

Phone

(773) 746-2964

NPI assigned

Jul 29, 2021

Last updated

Mar 8, 2022By 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

Dr. Brett Walters, MD

Title

Member

Phone

(773) 746-2964

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1659044162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 736198",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753736198",
            "telephone_number": "773-746-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6517 PERSIMMON TREE RD",
            "city": "CABIN JOHN",
            "state": "MD",
            "postal_code": "208181216",
            "telephone_number": "773-746-2964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOCO WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-29",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "773-746-2964",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093098329",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Lee Marquier-Schacht, PH.D.
• Gabriel Martinez, LCPC
• Ilene Marto Atiyah, LMSW
• MJM Anesthesia ,LLC
• MLM Anesthesia LLC
• Doreen Moreira, M.D.
• Melissa Myers
• Jennifer E Olson, LGPC
• Christopher Peckham, LCPC
• David Pickar, M.D.

• Public Health or Welfare Agency in Cabin John, MD
• Providers in Cabin John, MD by specialty
• Public Health or Welfare Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.