Wellvana North Carolina, LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

WELLVANA NORTH CAROLINA, LLC

Practice address

20 Burton Hills Blvd Ste 100
Nashville, TN 37215-6409

Phone

(860) 501-7908

NPI assigned

Sep 2, 2022

Organization subpart

No

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

Authorized official

Name

Catherine Smith

Title

VP Operations

Phone

(860) 501-7908

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1932829454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 CENTENNIAL BLVD",
            "address_2": "STE 202 PMB 4",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 BURTON HILLS BLVD STE 100",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156409",
            "telephone_number": "860-501-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLVANA NORTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-02",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "VP OPERATIONS",
        "authorized_official_telephone_number": "860-501-7908"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wellvana Maryland, LLC
• Wellvana Michigan LLC
• Wellvana Mississippi LLC
• Wellvana New Mexico LLC
• Wellvana New Mexico LLC
• Wellvana Premier Care, LLC
• Wellvana San Antonio LLC
• Wellvana South Carolina LLC
• Wellvana Tennessee LLC
• Wellvana Texas LLC

• Exclusive Provider Organization in Nashville, TN
• Providers in Nashville, TN by specialty
• Exclusive Provider Organization in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.