NPIMap

Organization Active NPI

Welllife, LLC

Doing business as WellLife Medical Centers

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1801597257
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
WELLLIFE, LLC
Doing business as
WellLife Medical Centers
Practice address
975 Garden of the Gods Rd Ste E
Colorado Springs, CO 80907-3434
Phone
(719) 694-8782
Fax
(719) 694-9375
NPI assigned
Mar 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Susan Germaine Jones, FNP-BCNPI 1639347107
Title
Clinic Director
Phone
(719) 694-8782

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

975 Garden of the Gods Rd Ste E
Colorado Springs, CO 80907-3434

Mailing address

975 Garden of the Gods Rd Ste E
Colorado Springs, CO 80907-3434
Phone (719) 694-8782

Other names 1

  • WellLife Medical Centers Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2339385Welllife LLC975 Garden of the Gods Rd, Suite E, Colorado Springs, CO 80907Certificate of waiverMar 1, 2028

National Provider Directory

National Provider Directory

Locations

975 Garden of the Gods Rd
Ste E
Colorado Springs, CO 80907
Phone (719) 694-8782

Practitioners & affiliated clinicians

Practitioners 3

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": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1801597257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 GARDEN OF THE GODS RD STE E",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073434",
            "telephone_number": "719-694-8782",
            "fax_number": "719-694-9375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 GARDEN OF THE GODS RD STE E",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073434",
            "telephone_number": "719-694-8782",
            "fax_number": "719-694-9375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLLIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "GERMAINE",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "719-694-8782",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellLife Medical Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.