Addictive Wellness, LLC

Primary specialty

Infusion Therapy Registered NurseTaxonomy code 163WI0500X

Legal business name

ADDICTIVE WELLNESS, LLC

Practice address

1630 Santa Fe St
Waynoka, OK 73860-3946

Phone

(580) 216-9554

NPI assigned

Feb 12, 2025

Organization subpart

No

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

Authorized official

Name

Thomas Minichiello Jr., RN, HHP

Title

RN/Holistic Health Practitioner

Phone

(580) 216-9554

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1739318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1699580894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9929 COUNTY ROAD 350",
            "city": "WAYNOKA",
            "state": "OK",
            "postal_code": "738606934",
            "telephone_number": "580-216-9554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 SANTA FE ST",
            "city": "WAYNOKA",
            "state": "OK",
            "postal_code": "738603946",
            "telephone_number": "580-216-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDICTIVE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "MINICHIELLO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "RN/HOLISTIC HEALTH PRACTITIONER",
        "authorized_official_telephone_number": "580-216-9554",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RN, HHP"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alva Hospital Authority/Dba Share Medical Center
• Tamara Bolar
• Susan Jeanice Bradford
• Milissa A Britt
• Mackenzie Rae Brune, PRSS

• Infusion Therapy Registered Nurse in Waynoka, OK
• Providers in Waynoka, OK by specialty
• Infusion Therapy Registered Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.