Integrative Health Recreation & Musu Wellness Coaching

Primary specialty

Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X

Legal business name

INTEGRATIVE HEALTH RECREATION & MUSU WELLNESS COACHING

Practice address

202 E Diamond Ave
Gaithersburg, MD 20877-3014

Phone

(240) 478-5843

NPI assigned

Dec 21, 2022

Organization subpart

No

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

Authorized official

Name

Mamie Musu F Wheeler

Title

Administrator

Phone

(240) 478-5843

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691712000000",
    "number": "1952013963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E DIAMOND AVE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208773014",
            "telephone_number": "240-478-5843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E DIAMOND AVE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208773014",
            "telephone_number": "240-478-5843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE HEALTH RECREATION & MUSU WELLNESS COACHING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-21",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "MAMIE",
        "authorized_official_middle_name": "MUSU F",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "240-478-5843"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "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 Aug 11, 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.