Sib Wellness Solutions LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SIB WELLNESS SOLUTIONS LLC

Practice address

2105 N Washington Ave
Roswell, NM 88201-3369

Phone

(248) 707-9554

NPI assigned

Mar 20, 2025

Organization subpart

No

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

Authorized official

Name

Samuel Basiaka Itie, PMHNP-BCNPI 1952794687

Title

Ceo/Provider

Phone

(248) 707-9554

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Practitioners 1

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

• Samuel Basiaka Itie, FNP-C

  • Family Nurse Practitioner
  • Roswell, NM
  • NPI 1952794687

  Psychiatric/Mental Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1742428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1861293516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 N WASHINGTON AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013369",
            "telephone_number": "248-707-9554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 N WASHINGTON AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013369",
            "telephone_number": "248-707-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIB WELLNESS SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-20",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A",
        "authorized_official_last_name": "ITIE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "BASIAKA",
        "authorized_official_title_or_position": "CEO/PROVIDER",
        "authorized_official_telephone_number": "248-707-9554",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ninad P Shet, MD
• Nishka U Shetty, MBBS
• Tara Renee Shields, , B.A.
• Shiloh Birth LLC
• Siavash Karimian MD of New Mexico PC Dba Roswell Medico
• Richard J Sidd, MD
• Monique Breannah Sigala
• Czarino Paragas Silao, P.T.
• Sandra Corina Silvas
• Victor Silvas

• Psychiatric/Mental Health Nurse Practitioner in Roswell, NM
• Providers in Roswell, NM by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.