NPIMap

Organization Active NPI

Old Towne Wellness, LLC

  • Psychiatry Physician
  • Mechanicsville, VA
National Provider Identifier
1891267761
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
OLD TOWNE WELLNESS, LLC
Practice address
7489 Right Flank Rd Ste 330
Mechanicsville, VA 23116-3845
Phone
(804) 938-8884
Fax
(804) 789-8881
NPI assigned
Dec 17, 2018
Last updated
Dec 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Authorized official

Name
Ms. Jeri D Lewis, LPCNPI 1902816341
Title
Owner
Phone
(804) 938-8884

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
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

7489 Right Flank Rd Ste 330
Mechanicsville, VA 23116-3845

Mailing address

7489 Right Flank Rd Ste 330
Mechanicsville, VA 23116-3845
Phone (804) 938-8884

National Provider Directory

National Provider Directory

Locations

7489 Right Flank Rd
Ste 330
Mechanicsvlle, VA 23116

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545004800000",
    "number": "1891267761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7489 RIGHT FLANK RD STE 330",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231163845",
            "telephone_number": "804-938-8884",
            "fax_number": "804-789-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7489 RIGHT FLANK RD STE 330",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231163845",
            "telephone_number": "804-938-8884",
            "fax_number": "804-789-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TOWNE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JERI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-938-8884",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.