NPIMap

Organization Active NPI

Wellness of North Carolina PLLC

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1679937205
Registry record updated Apr 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31845 Issued in NC
Legal business name
WELLNESS OF NORTH CAROLINA PLLC
Practice address
13521 Steelecroft Pkwy Ste B
Charlotte, NC 28278-7889
Phone
(646) 729-7578
NPI assigned
Apr 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2016

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

Authorized official

Name
Thomas Joseph Mullen
Title
President/Ceo
Phone
(646) 729-7578

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 31845 NC Primary

Addresses

Primary practice location

13521 Steelecroft Pkwy Ste B
Charlotte, NC 28278-7889

Mailing address

13521 Steelecroft Pkwy Ste B
Charlotte, NC 28278-7889
Phone (646) 729-7578

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2112398Wellness of North Carolina, PLLC13521 Steelecroft Parkway, Ste B, Charlotte, NC 28278Certificate of waiverApr 27, 2028

National Provider Directory

National Provider Directory

Locations

13521 Steelecroft Pkwy
Ste D
Charlotte, NC 28278
Phone (704) 315-5845

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1460246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460246400000",
    "number": "1679937205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13521 STEELECROFT PKWY STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787889",
            "telephone_number": "646-729-7578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13521 STEELECROFT PKWY STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787889",
            "telephone_number": "646-729-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS OF NORTH CAROLINA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-10",
        "last_updated": "2016-04-10",
        "status": "A",
        "authorized_official_last_name": "MULLEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "646-729-7578"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "31845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2016; 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.

Verify at the official NPI Registry.