Organization Active NPI

Total Wellness Inc

  • Registered Dietitian
  • Bay Shore, NY
National Provider Identifier
1699826263
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
000691-1 Issued in NY
Legal business name
TOTAL WELLNESS INC
Practice address
160 Howells Rd
Bay Shore, NY 11706-5320
Phone
(631) 666-4297
NPI assigned
Jan 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Marlisa Brown, MS RD CDE CDNNPI 1871666941
Title
President
Phone
(631) 666-4297

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 000691-1 NY Primary

Addresses

Primary practice location

160 Howells Rd
Bay Shore, NY 11706-5320

Mailing address

160 Howells Rd
Bay Shore, NY 11706-5320
Phone (631) 666-4297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311000560 NY Part B Supplier - Clinic/Group Practice 8224927074 Receives reassigned benefits from 1 practitioner
Practice locations: Bay Shore, NY; Deer Park, NY

National Provider Directory

National Provider Directory

Locations

375 Commack Rd
Ste 201
Deer Park, NY 11729
Phone (631) 666-4297

Practitioners & affiliated clinicians

Practitioners 2

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": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699826263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 HOWELLS RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117065320",
            "telephone_number": "631-666-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 HOWELLS RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117065320",
            "telephone_number": "631-666-4297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MARLISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-666-4297",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS RD CDE CDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "000691-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.