NPIMap

Organization Active NPI

Wellness Ambulatory Care Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Knoxville, TN
National Provider Identifier
1891246658
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
I000000019002 Issued in TN
Legal business name
WELLNESS AMBULATORY CARE INC.
Practice address
6624 Central Avenue Pike
Suite 101
Knoxville, TN 37912-1400
Phone
(865) 851-9023
Fax
(865) 951-1966
NPI assigned
Oct 17, 2016
Last updated
Dec 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Authorized official

Name
Mrs. Jemece Gasaway, MSW, LMSQ
Title
Director of Licensing
Phone
(214) 365-6126

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X I000000019002 TN Primary

Addresses

Primary practice location

6624 Central Avenue Pike
Suite 101
Knoxville, TN 37912-1400

Mailing address

5001 Spring Valley Rd Ste 600
Dallas, TX 75244-3946
Phone (214) 364-6100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210120000765 TN Part B Supplier - Clinic/Group Practice 2163703901 Receives reassigned benefits from 29 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Savannah, TN; Paris, TN; Nashville, TN; Murfreesboro, TN; Memphis, TN; Knoxville, TN; Jackson, TN; Dyersburg, TN…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

Locations

640 US Highway 51 Byp E
Ste L
Dyersburg, TN 38024
Phone (731) 285-6535

58 Carriage House Dr
Ste B
Jackson, TN 38305
Phone (731) 660-0880

6624 Central Avenue Pike
Ste 101
Knoxville, TN 37912
Phone (865) 851-9023

176 Cude Ln
Rm 1
Madison, TN 37115
Phone (615) 281-6757

1734 Madison Ave
Rm 161
Memphis, TN 38104
Phone (901) 722-9420

2410 Charlotte Ave
Nashville, TN 37203
Phone (615) 321-2575

342 22nd Ave N
Rm 144
Nashville, TN 37203
Phone (615) 321-2575

2555 E Wood St
Rm 101
Paris, TN 38242
Phone (731) 641-4545

85 Harrison St
Rm 101
Savannah, TN 38372
Phone (731) 925-2767

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606867200000",
    "number": "1891246658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 SPRING VALLEY RD STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443946",
            "telephone_number": "214-364-6100",
            "fax_number": "214-365-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6624 CENTRAL AVENUE PIKE",
            "address_2": "SUITE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379121400",
            "telephone_number": "865-851-9023",
            "fax_number": "865-951-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS AMBULATORY CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A",
        "authorized_official_last_name": "GASAWAY",
        "authorized_official_first_name": "JEMECE",
        "authorized_official_title_or_position": "DIRECTOR OF LICENSING",
        "authorized_official_telephone_number": "214-365-6126",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW, LMSQ"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TN",
            "license": "I000000019002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.