NPIMap

Organization Active NPI

Compassionate Wellness Center, LLC

  • Internal Medicine Physician
  • Hagerstown, MD
National Provider Identifier
1871088682
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D70102 Issued in MD
Legal business name
COMPASSIONATE WELLNESS CENTER, LLC
Practice address
44 N Potomac St Ste 101&102
Hagerstown, MD 21740-4855
Phone
(240) 513-6001
Fax
(240) 513-6122
NPI assigned
Jun 25, 2018
Last updated
Jun 25, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
COMPASSIONATE WELLNESS CENTER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Authorized official

Name
Dr. Ivan Ngang Zama, MD
Title
President
Phone
(240) 513-6001

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D70102 MD Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X D70102 MD

Addresses

Primary practice location

44 N Potomac St Ste 101&102
Hagerstown, MD 21740-4855

Mailing address

10319 Westlake Dr Ste 335
Bethesda, MD 20817-6403
Phone (240) 513-6001

National Provider Directory

National Provider Directory
Tax ID family
Compassionate Wllnss CNTR7 organizations share this tax ID, including this one
Part of
Compassionate Wllnss CNTR

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529884800000",
    "number": "1871088682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10319 WESTLAKE DR STE 335",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208176403",
            "telephone_number": "240-513-6001",
            "fax_number": "240-513-6122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 N POTOMAC ST STE 101&102",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217404855",
            "telephone_number": "240-513-6001",
            "fax_number": "240-513-6122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASSIONATE WELLNESS CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMPASSIONATE WELLNESS CENTER, LLC",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A",
        "authorized_official_last_name": "ZAMA",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "NGANG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-513-6001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D70102",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MD",
            "license": "D70102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.