Wellness 360 LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WELLNESS 360 LLC

Practice address

145 Route 34
Matawan, NJ 07747-2187

Phone

(732) 719-6864

NPI assigned

Sep 25, 2023

Organization subpart

No

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

Authorized official

Name

Anant Nischal, PA, PHDNPI 1023291887

Title

Owner, PA

Phone

(732) 719-6864

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Anant Kumarie Nischal, PHD-IMD, P.A

  • Medical Physician Assistant
  • Staten Island, NY
  • NPI 1023291887
  NPD (past) Authorized official

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1689453250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PERRINE RD STE 230",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572871",
            "telephone_number": "732-707-3545",
            "fax_number": "732-707-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 ROUTE 34",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472187",
            "telephone_number": "732-719-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS 360 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-24",
        "status": "A",
        "authorized_official_last_name": "NISCHAL",
        "authorized_official_first_name": "ANANT",
        "authorized_official_title_or_position": "OWNER, PA",
        "authorized_official_telephone_number": "732-719-6864",
        "authorized_official_credential": "PA, PHD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Edward Weber, DDS
• Claudia Fortuny Webster
• Allison Weinberger, M.S. CCC-SLP
• Welcome Home Foundation, Inc.
• Wellcare Holistics
• Miranda Wells, RBT
• Jenna Welsh, LPC
• Samantha West, LAC
• Breanan Marie Whalen
• Daniel F Whitener

• Family Medicine Physician in Matawan, NJ
• Providers in Matawan, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.