INNOVATIVE WELLNESS LLC (NPI# 1861093254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861093254 |
| Entity Type | Organization |
| Organization Name | INNOVATIVE WELLNESS LLC |
| Practice Address |
4985 Smoketalk Ln Westerville OH 43081-4432 |
| Practice Telephone | 9542600104 |
| Practice Fax Number | 8334103619 |
| Mailing Telephone | 9542600104 |
| Mailing Fax Number | 8334103619 |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2020-11-03 |
| Authorized Official Name | JAY BOULDIN (ADMINISTRATOR) |
| Authorized Official Telephone | 9542600104 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
4985 SMOKETALK LN |
| City | WESTERVILLE |
| State | OH |
| Zip Code | 43081-4432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952917643 | Cheryl Lynne Weitthoff | Home Health Aide | Cheryl Weitthoff, 33 Nadine Place South, Westerville, OH 43081 | 2020-09-18 |
| 1588274088 | Omer Mohamed | Respiratory Therapist, Certified | 5825 Leila Lane Unit 107, Westerville, OH 43081 | 2020-08-09 |
| 1932739174 | Norline E Ford | Counselor | 100 Dorchester Sq. Suite 102, Westerville, OH 43081 | 2020-01-15 |
| 1902444524 | Sabrina Shannon | Behavior Technician | 189 W. Schrock Road, Westerville, OH 43081 | 2019-12-13 |
| 1336786581 | New Horizon Home Health Care, LLC | Home Health | 635 Park Meadow Rd Ste 115, Unit B, Westerville, OH 43081 | 2019-12-06 |
| 1295389740 | Esther A Ogundare | Licensed Practical Nurse | 394 Naples Pl., Westerville, OH 43081 | 2019-08-01 |
| 1922580364 | Judith Luann Haynes | Nurse Practitioner | 620 S. Cleveland Ave, Westerville, OH 43081 | 2018-09-01 |
| 1851879878 | Erin Doone | Physical Therapist | 631 Copeland Mill Rd Ste B, Westerville, OH 43081 | 2018-08-01 |
| 1205312360 | Melissa Anderson | Counselor | 145 W Schrock Road, Westerville, OH 43081 | 2018-07-12 |
| 1407344963 | Hannah Tiberi | Nurse Practitioner | 410 Mary Ave, Westerville, OH 43081 | 2018-04-30 |
| Find all providers in zip 43081 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184158743 | Hope Recovery Center LLC | Internal Medicine | 387 County Line Rd W, Westerville, OH 43082-6080 | 2017-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861916330 | First Horizon Solutions, LLC | Internal Medicine | 3730 Tabs Dr Ste 102, Uniontown, OH 44685-9562 | 2017-07-27 |
| 1558800193 | Cleanslate Medical Group of Ohio LLC | Internal Medicine | 4488 W Broad St Ste 3, Columbus, OH 43228-5610 | 2017-02-15 |
| 1841238094 | Christopher T. Meyer | Internal Medicine | 75 Hospital Dr Ste 350, Athens, OH 45701-2867 | 2006-06-02 |
| 1417933490 | James Frederick Guenther | Internal Medicine | 1319 E Main St, Lancaster, OH 43130-4005 | 2005-12-21 |
| 1528051661 | Cynthia L Brown | Internal Medicine | 2351 E 22nd St, St Vincent Charity Hospital Attn: Gma Consultants, Cleveland, OH 44115-3111 | 2005-08-24 |
| 1639170509 | Patrick Bruno | Internal Medicine | 3535 Lee Rd, Shaker Heights, OH 44120-5122 | 2005-08-02 |
| 1649279373 | Anthony Dean Agra | Internal Medicine | 547 E 11th Ave, Columbus, OH 43211-2603 | 2005-07-15 |
| 1245233345 | Parag J Patel | Internal Medicine | 446 Morgan St, Cincinnati, OH 45206-2348 | 2005-05-23 |
| 1790382752 | Keyona Shine | Internal Medicine | 2101 Silver Maple Way, Lorain, OH 44053-2380 | 2020-10-02 |
| 1902413677 | Stacey Whitesel | Internal Medicine | 2101 Silver Maple Way, Lorain, OH 44053-2380 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
| City | WESTERVILLE |
| Zip Code | 43081 |
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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.