WELLNESS SOURCE LLC (NPI# 1114420320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114420320 |
| Entity Type | Organization |
| Organization Name | WELLNESS SOURCE LLC |
| Other Organization Name | YOUR WELLNESS SOURCES |
| Practice Address |
6305 Ivy Ln Ste 101 Greenbelt MD 20770-6326 |
| Practice Telephone | 3012350060 |
| Mailing Telephone | 3012350060 |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2018-03-14 |
| Authorized Official Name | DR. MARSHALEE GEORGE (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 3012350060 |
| Authorized Official Credential | PHD, CRNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| Other Name | Type Code |
|---|---|
| Your Wellness Sources | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205339413 | Wellness Source LLC | Social Worker | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2018-03-14 |
| 1780031724 | Wellness Source LLC | Clinic/Center | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-1465 | 2016-05-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WELLNESS SOURCE LLC | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 |
| Street Address |
6305 IVY LN STE 101 |
| City | GREENBELT |
| State | MD |
| Zip Code | 20770-6326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508827809 | Bernadette Assumpta Bangnam | Registered Nurse | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2006-03-28 |
| 1225643000 | Advanced Healthcare and Allied Services, LLC | Community/Behavioral Health | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2020-09-09 |
| 1255945242 | Advanced Healthcare and Allied Services, LLC | Nurse Practitioner | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2020-09-07 |
| 1174160980 | Survivor Sources Inc | Case Manager/Care Coordinator | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2019-11-30 |
| 1356907844 | Peter Devlin | Social Worker | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2019-05-10 |
| 1972166163 | Advanced Healthcare & Allied Services, Inc. | Home Health | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2019-04-15 |
| 1760966436 | Akos Antwi | Registered Nurse | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2018-09-19 |
| 1205339413 | Wellness Source LLC | Social Worker | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2018-03-14 |
| 1619477478 | Divya Lakshmi Selvakumar | Dietitian, Registered | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2018-02-19 |
| 1780031724 | Wellness Source LLC | Clinic/Center | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-1465 | 2016-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841805405 | Caring Hands Medical Clinic LLC | Nurse Practitioner | 7201 Handover Parkway, Suite B, Greenbelt, MD 20770 | 2020-09-10 |
| 1770107203 | Jeannette Nicole Welds | Social Worker | 7710-303 Hanover Parkway, Greenbelt, MD 20770 | 2020-06-01 |
| 1063032597 | Victory Clinical Research | Specialist | 7212 Hanover Parkway, Suite A, Greenbelt, MD 20770 | 2020-04-24 |
| 1336793884 | Yan Chen | Physician Assistant | 7300 Hanover Drive, Suite 104, Greenbelt, MD 20770 | 2019-08-01 |
| 1245884519 | Antonio Moody | Counselor | 7474 Greenbelt Center Drive, Greenbelt, MD 20770 | 2019-07-25 |
| 1881166494 | Jeniece Edwina Weddington | Speech-Language Pathologist | Eleanor Roosevelt High School- Pgcps, 7601 Hanover Parkway, Greenbelt, MD 20770 | 2018-12-20 |
| 1043797996 | Thomas Mesumbe | Home Health Aide | 6204 Sringhill Drive, Apartment 201, Greenbelt, MD 20770 | 2018-07-24 |
| 1063914554 | Zainab Anita Foday | Home Health Aide | 5923 Cherrywood Terrace Apt 101, Greenbelt, MD 20770 | 2018-03-01 |
| 1619479193 | Nancy Benga | Home Health Aide | 5821 Cherrywood Ln Apt 104 5821 Cherry Wood Ln Apt 104, Greenbelt, MD 20770 | 2018-03-01 |
| 1912407891 | Adoni Healthcare Services, LLC | Clinic/Center | 7525 Greenway Center Dr Ste 316, Greenbelt, MD 20770 | 2018-02-16 |
| Find all providers in zip 20770 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497392229 | Bramaramba Kowtha | Dietitian, Registered | 8009 Craddock Rd, Greenbelt, MD 20770-3052 | 2019-11-27 |
| 1356859821 | Antoinette Michelle Hinds | Dietitian, Registered | 6936 Hanover Pkwy Apt 302, Greenbelt, MD 20770-2215 | 2018-01-17 |
| 1629437686 | Kaitlin Williams Eckstein | Dietitian, Registered | 6301 Ivy Ln Ste 410, Greenbelt, MD 20770-6357 | 2016-02-18 |
| 1568790541 | Shelley Lewis | Dietitian, Registered | 7219 D Hanover Pkwy Suite D, Greenbelt, MD 20770 | 2009-12-02 |
| 1033213566 | Rebecca S Bitzer | Dietitian, Registered | 7219 Hanover Pkwy Ste D, Greenbelt, MD 20770-2021 | 2006-09-13 |
| 1164020574 | Kristin Jenkins | Dietitian, Registered | 6301 Ivy Ln Ste 410, Greenbelt, MD 20770-6357 | 2020-10-16 |
| 1902467566 | Allie Hosmer | Dietitian, Registered | 7219 Hanover Pkwy Ste D, Greenbelt, MD 20770-2021 | 2019-06-25 |
| 1750861613 | Kathleen Tabb | Dietitian, Registered | 7219 Hanover Pkwy Ste D, Greenbelt, MD 20770-2021 | 2018-08-20 |
| 1619477478 | Divya Lakshmi Selvakumar | Dietitian, Registered | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2018-02-19 |
| 1255845798 | Edita Veronica Tituana | Dietitian, Registered | 9220 Springhill Ln, Greenbelt, MD 20770-1203 | 2017-11-20 |
| Find all providers in GREENBELT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.