Rockwall Colonics & Wellness Center LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ROCKWALL COLONICS & WELLNESS CENTER LLC

Doing business as

Rockwall Complete Healing and Wellness

Practice address

2455 Ridge Rd Ste 151
Rockwall, TX 75087-5538

Phone

(972) 771-8900

NPI assigned

Jul 21, 2020

Organization subpart

No

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

Authorized official

Name

Dominique M Robinson

Title

Owner

Phone

(972) 771-8900

Specialties & licenses 1

Addresses

Other names 1

• Rockwall Complete Healing and Wellness Doing business as

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Dana Logwood, NP-C

  • Family Nurse Practitioner
  • Rowlett, TX
  • NPI 1114393154
  NPD

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1912515404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 RIDGE RD STE 151",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750875538",
            "telephone_number": "972-771-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 RIDGE RD STE 151",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750875538",
            "telephone_number": "972-771-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKWALL COLONICS & WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-21",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-771-8900"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rockwallcolonics@att.net",
            "affiliation": "N",
            "endpointDescription": "Office email",
            "address_1": "2455 Ridge Rd Ste 151",
            "city": "Rockwall",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750875538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Rockwall Complete Healing and Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rockwall Complete Healing and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Care Clinic/Center in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.