Reconnect Wellness Laurel, LLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

RECONNECT WELLNESS LAUREL, LLC

Practice address

910 Sawmill Rd Ste D29
Laurel, MS 39440-3961

Phone

(601) 342-5948

NPI assigned

Feb 17, 2017

Organization subpart

No

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

Authorized official

Name

Douglas M Wright Jr.

Title

Managing Member Reconnect Outpatien

Phone

(662) 680-3148

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487289600000",
    "number": "1932648367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3667",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388033667",
            "telephone_number": "166-268-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 SAWMILL RD STE D29",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394403961",
            "telephone_number": "601-342-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECONNECT WELLNESS LAUREL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-17",
        "last_updated": "2017-02-17",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING MEMBER RECONNECT OUTPATIEN",
        "authorized_official_telephone_number": "16626803148",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; 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.