Physician Wellness Professional Association

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PHYSICIAN WELLNESS PROFESSIONAL ASSOCIATION

Practice address

10430 Park Road Suite 100a
Charlotte, NC 28210

Phone

(704) 259-7933

Fax

(704) 899-5668

NPI assigned

Feb 20, 2019

Last updated

Feb 20, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William G Reilly, MD

Title

Authorized Official

Phone

(817) 410-3800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1871059378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 EAST STATE HIGHWAY 114",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "76092",
            "telephone_number": "817-410-3800",
            "fax_number": "817-410-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10430 PARK ROAD SUITE 100A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28210",
            "telephone_number": "704-259-7933",
            "fax_number": "704-899-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN WELLNESS PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-20",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "REILLY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "817-410-3800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Phung
• Physical Therapy Center Two, LLC (Physical Therapy Center, LLC)
• Physical Therapy Consultants Inc (KCP Physical Therapy)
• Physical Therapy for the Carolinas (PT for the Carolinas)
• Physician Home Care (Physicians Home Care)
• Physiofocus Orthopedic and Sports Therapy LLC
• Physiotherapy Associates Inc.
• Physiotherapy Associates, Inc.
• Phytcare LLC
• Phytcare LLC

• Internal Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.