The Modern Woman Health & Wellness Center PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

THE MODERN WOMAN HEALTH & WELLNESS CENTER PLLC

Practice address

504 Wolcott Rd Ste C
Wolcott, CT 06716-2462

Phone

(203) 504-9507

NPI assigned

Mar 23, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Shivanna Subramani-Gonzalez, DNP-FNPCNPI 1457758179

Title

Cmo / Owner

Phone

(203) 725-5339

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

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

CLIA laboratory certificates

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• TMW Wellness PLLC

  • Mental Health Counselor
  • Wolcott, CT
  • NPI 1700580198
  NPPES parent name
• TMW Wellness PLLC

  • Mental Health Counselor
  • Wolcott, CT
  • NPI 1912601402
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shivanna Subramani Gonzalez, DNP

  • Family Nurse Practitioner
  • Wolcott, CT
  • NPI 1457758179

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Melynda Ramona Cabrera, MS, NCC, LPC

  • Professional Counselor
  • Southbury, CT
  • NPI 1811329246
  NPD
• Jeffrey Gonzalez, LPC-A

  • Counselor
  • Wolcott, CT
  • NPI 1285405928
  NPD

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680048000000",
    "number": "1801599295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 WOLCOTT RD STE C",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162462",
            "telephone_number": "203-504-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 WOLCOTT RD STE C",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162462",
            "telephone_number": "203-504-9507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MODERN WOMAN HEALTH & WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A",
        "authorized_official_last_name": "SUBRAMANI-GONZALEZ",
        "authorized_official_first_name": "SHIVANNA",
        "authorized_official_title_or_position": "CMO / OWNER",
        "authorized_official_telephone_number": "203-725-5339",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP-FNPC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shivanna Subramani Gonzalez, DNP
• David M Suhocki, PA
• Superior Health Care of CT, LLC
• Michael F Swierczynski, D.C.
• Taylor Nicole Tardif
• Cynthia Lynn Thibodeau, M.S.,CCC-SLP
• Christine M Thorn, D.C.
• TMW Wellness PLLC
• TMW Wellness PLLC
• Christian Toro

• Family Nurse Practitioner in Wolcott, CT
• Providers in Wolcott, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.