NPIMap

Organization Active NPI

Wellness Source LLC

Doing business as Your Wellness Sources

  • Family Nurse Practitioner
  • Hyattsville, MD
National Provider Identifier
1780031724
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
WELLNESS SOURCE LLC
Doing business as
Your Wellness Sources
Practice address
4301 Garden City Dr Ste 304
Hyattsville, MD 20785-6105
Phone
(301) 235-0060
Fax
(240) 324-7720
NPI assigned
May 19, 2016
Last updated
Oct 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Authorized official

Name
Marshalee GeorgeNPI 1952370272
Title
Ceo, Medical Director
Phone
(301) 235-0060

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 12

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Family Nurse Practitioner 363LF0000X Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Women's Health Nurse Practitioner 363LW0102X
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X
Oncology Clinical Nurse Specialist 364SX0200X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X
Psychiatry Physician 2084P0800X
Addiction Psychiatry Physician 2084P0802X
Podiatrist 213E00000X

Addresses

Primary practice location

4301 Garden City Dr Ste 304
Hyattsville, MD 20785-6105

Mailing address

4301 Garden City Dr Ste 304
Hyattsville, MD 20785-6105
Phone (301) 235-0600

Other identifiers 6

IdentifierTypeStateIssuer
600082700MedicaidMD
971669MedicaidNJ
051747821MedicaidDC
30015268390002MedicaidVA
250781180MedicaidDE
540582OtherMDMEDICARE PTAN

Other names 2

  • Your Wellness Sources Doing business as
  • Your Wellness Sources - Primary Care Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161118000825 DC Part B Supplier - Clinic/Group Practice 2668751454 Receives reassigned benefits from 17 practitioners
Practice locations: Hyattsville, MD

National Provider Directory

National Provider Directory

Locations

4301 Garden City Dr
Landover, MD 20785
Phone (301) 459-8252

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792022400000",
    "number": "1780031724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 GARDEN CITY DR STE 304",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207856105",
            "telephone_number": "301-235-0600",
            "fax_number": "240-324-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 GARDEN CITY DR STE 304",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207856105",
            "telephone_number": "301-235-0060",
            "fax_number": "240-324-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS SOURCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-19",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "MARSHALEE",
        "authorized_official_title_or_position": "CEO, MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "301-235-0060"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SX0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600082700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "971669",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051747821",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30015268390002",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250781180",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "540582",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Your Wellness Sources",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Your Wellness Sources",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Your Wellness Sources - Primary Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; 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.