NPIMap

Organization Active NPI

Wellave, LLC

  • Medical Specialty Clinic/Center
  • Frederick, MD
National Provider Identifier
1891159661
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
WELLAVE, LLC
Practice address
411 Aviation Way Ste 245
Frederick, MD 21701
Phone
(888) 820-3376
Fax
(888) 826-4576
NPI assigned
Apr 7, 2016
Last updated
Aug 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Authorized official

Name
Ms. Eileen DoaneNPI 1225480106
Title
President
Phone
(240) 994-0867

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

411 Aviation Way Ste 245
Frederick, MD 21701

Mailing address

411 Aviation Way Ste 245
Frederick, MD 21701-3125
Phone (888) 820-3376

Other practice location 1

155 Gibbs St
Unit 419
Rockville, MD 20850-0353
Phone (301) 424-8620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170222002013 MD Part B Supplier - Clinic/Group Practice 0648563015 Receives reassigned benefits from 17 practitioners
Practice locations: Easton, MD; Frederick, MD; Gambrills, MD; Hagerstown, MD; Nottingham, MD; Salisbury, MD; Annapolis, MD; Stevensville, MD…

National Provider Directory

National Provider Directory

Locations

130 Admiral Cochrane Dr
Ste 300
Annapolis, MD 21401
Phone (410) 571-1280

1935 Generals Hwy
Ste E
Annapolis, MD 21401

4507 Stanford St
Chevy Chase, MD 20815
Phone (443) 302-9258

5555 Friendship Blvd
Ste 100
Chevy Chase, MD 20815

4 Caulk Ln
Ste C
Easton, MD 21601
Phone (410) 822-7440

1071 State Route 3 N
Ste 101
Gambrills, MD 21054
Phone (410) 721-2333

11236 Robinwood Dr
Ste 204
Hagerstown, MD 21742

9210 Kentsdale Dr
Potomac, MD 20854

1515 Dunster Rd
Rockville, MD 20854

155 Gibbs St
Unit 419
Rockville, MD 20850
Phone (301) 424-8620

1411 S Salisbury Blvd
Ste A
Salisbury, MD 21801

20 University Blvd E
Ste 20
Silver Spring, MD 20901

202 Saint Claire Pl
Stevensville, MD 21666

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533600000000",
    "number": "1891159661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 AVIATION WAY STE 245",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217013125",
            "telephone_number": "888-820-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 AVIATION WAY STE 245",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21701",
            "telephone_number": "888-820-3376",
            "fax_number": "888-826-4576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Gibbs St",
            "address_2": "Unit 419",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208500353",
            "country_code": "US",
            "telephone_number": "301-424-8620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLAVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-07",
        "last_updated": "2018-08-07",
        "status": "A",
        "authorized_official_last_name": "DOANE",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-994-0867",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.