NPIMap

Organization Active NPI

State of Wellness, Inc

  • Health Educator
  • Columbia, MD
National Provider Identifier
1700241577
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Legal business name
STATE OF WELLNESS, INC
Practice address
9622 Basket Ring Road
Columbia, MD 21045-3418
Phone
(410) 715-2268
Fax
(433) 925-9565
NPI assigned
Dec 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

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

Authorized official

Name
Michaela Ann Conley, MS, MCHES
Title
Executive Director
Phone
(410) 715-2268

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health EducatorGroup: 193400000X SINGLE SPECIALTY GROUP 174H00000X MD Primary

Addresses

Primary practice location

9622 Basket Ring Road
Columbia, MD 21045-3418

Mailing address

9622 Basket Ring Road
Columbia, MD 21045-3418
Phone (410) 715-2268

National Provider Directory

National Provider Directory
Tax ID family
State of Wellness2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450742400000",
    "number": "1700241577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9622 BASKET RING ROAD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453418",
            "telephone_number": "410-715-2268",
            "fax_number": "443-926-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9622 BASKET RING ROAD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453418",
            "telephone_number": "410-715-2268",
            "fax_number": "433-925-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF WELLNESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A",
        "authorized_official_last_name": "CONLEY",
        "authorized_official_first_name": "MICHAELA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-715-2268",
        "authorized_official_credential": "MS, MCHES"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health Educator",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; 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.