NPIMap

Organization Active NPI

Wellspace Nexus

  • Exclusive Provider Organization
  • Sacramento, CA
National Provider Identifier
1962149864
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
Legal business name
WELLSPACE NEXUS
Practice address
777 12TH St Ste 250
Sacramento, CA 95814-1929
Phone
(916) 737-5555
NPI assigned
May 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Authorized official

Name
Dr. Jonathan Porteus, PHD
Title
Ceo
Phone
(916) 737-5577

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X SINGLE SPECIALTY GROUP 171M00000X
Exclusive Provider Organization 302F00000X Primary

Addresses

Primary practice location

777 12TH St Ste 250
Sacramento, CA 95814-1929

Mailing address

777 12TH St Ste 250
Sacramento, CA 95814-1929
Phone (916) 737-5577

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://portal.wellspacenexus.org/php/general/index.php#med_dashboard_frame&link_module=31&link_id=189 Direct
CONNECT URL https://www.wellspacehealth.org/ Direct WellSpace Health

National Provider Directory

National Provider Directory

Locations

777 12th St
Sacramento, CA 95814

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1962149864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 12TH ST STE 250",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958141929",
            "telephone_number": "916-737-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 12TH ST STE 250",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958141929",
            "telephone_number": "916-737-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPACE NEXUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-13",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "PORTEUS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-737-5577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://portal.wellspacenexus.org/php/general/index.php#med_dashboard_frame&link_module=31&link_id=189",
            "affiliation": "N",
            "endpointDescription": "RBO website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "777 12th St",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958141926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.wellspacehealth.org/",
            "affiliation": "Y",
            "endpointDescription": "Clinic Website",
            "affiliationName": "WellSpace Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1820 J St",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958113010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.