Golden Phoenix Wellness Corporation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

GOLDEN PHOENIX WELLNESS CORPORATION

Practice address

600 Broadway Ste 200-4502
Albany, NY 12207-2236

Phone

(214) 405-5556

NPI assigned

Dec 8, 2021

Organization subpart

No

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

Authorized official

Name

Stephanie Fuller

Title

Co-Ceo

Phone

(214) 405-5556

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641427200000",
    "number": "1679232508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BROADWAY STE 200-4502",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BROADWAY STE 200-4502",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072236",
            "telephone_number": "214-405-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN PHOENIX WELLNESS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CO-CEO",
        "authorized_official_telephone_number": "214-405-5556"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Golchin, OD
• Louis H Gold, MD
• Meryl Emily Gold
• Joni Ann Goldberg, SLP
• Sophie Goldberg
• Kathryn Judith Golden, DC
• Lorrie Golden
• Rebecca Golderman Lobell
• Margaret Goldin Denio, PA
• Karen Lynn Goldman, LMHC

• Clinic/Center in Albany, NY
• Providers in Albany, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.