WELLNESS SOURCE LLC (NPI# 1780031724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780031724 |
| Entity Type | Organization |
| Organization Name | WELLNESS SOURCE LLC |
| Practice Address |
6305 Ivy Ln Ste 101 Greenbelt MD 20770-1465 |
| Practice Telephone | 3012350060 |
| Mailing Telephone | 3012350060 |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2017-07-31 |
| Authorized Official Name | DR. MARSHALEE GEORGE (DIRECTOR/NURSE PRACTITIONER) |
| Authorized Official Telephone | 3012350060 |
| Authorized Official Credential | PHD, CRNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 600082700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114420320 | Wellness Source LLC | Dietitian, Registered | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2018-03-14 |
| 1205339413 | Wellness Source LLC | Social Worker | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2018-03-14 |
| 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 | 20770-1465 |
| 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 |
| 1114420320 | Wellness Source LLC | Dietitian, Registered | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2018-03-14 |
| 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 |
| 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 | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205458502 | Oshoke Healthcare Services LLC | Clinic/Center | 7525 Greenway Center Dr, #316, Greenbelt, MD 20770 | 2020-05-11 |
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| 1982226023 | Complete Access Care, LLC | Clinic/Center | 1035 Ingleside Ave, Catonsville, MD 21228-1318 | 2020-05-12 |
| 1184245045 | Comfort Primary Care | Clinic/Center | 9966 Royal Commerce Pl, Upper Marlboro, MD 20774-1163 | 2020-05-01 |
| 1407476955 | Rcc Community Services, Inc | Clinic/Center | 2628 Harford Rd, Baltimore, MD 21218-4928 | 2020-04-24 |
| 1013536960 | Philomena Nufunkuen Keli | Clinic/Center | 15012 Saddle Creek Dr, Burtonsville, MD 20866-2211 | 2020-04-10 |
| 1629606454 | Advanced Primary Care | Clinic/Center | 525 Eastern Ave # B2, Fairmount Heights, MD 20743-1677 | 2020-03-28 |
| 1588211890 | Two Tree Health Associates, LLC | Clinic/Center | 10 S Hanson St Ste 21, Easton, MD 21601-3078 | 2019-08-21 |
| 1427604099 | Ecarenow LLC | Clinic/Center | 176 Thomas Johnson Dr Ste 203, Frederick, MD 21702-4535 | 2019-08-09 |
| 1326691874 | Lotus Healthcare and Wellness LLC | Clinic/Center | 6495 New Hampshire Ave Ste B140, Hyattsville, MD 20783-3245 | 2019-07-23 |
| 1831750546 | Matobi Family Healthcare,llc | Clinic/Center | 7350 Van Dusen Rd Ste 340, Laurel, MD 20707-5264 | 2019-06-24 |
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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.