WELLCARE, LLC (NPI# 1366469140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366469140 |
| Entity Type | Organization |
| Organization Name | WELLCARE, LLC |
| Practice Address |
18275 N 59th Ave Ste 138 Glendale AZ 85308-1253 |
| Practice Telephone | 6025640078 |
| Practice Fax Number | 6025641154 |
| Mailing Telephone | 6025640078 |
| Mailing Fax Number | 6025641154 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DEREK SEBADE (OWNER) |
| Authorized Official Telephone | 6025640078 |
| Authorized Official Credential | ANP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
082334 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 61944 | 05 |
| Street Address |
18275 N 59TH AVE STE 138 |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85308-1253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598782369 | Arrowhead Internal Medicine | Internal Medicine | 18275 N 59th Ave Ste 138, Glendale, AZ 85308-1253 | 2006-07-16 |
| 1811266208 | Elfat Rumman | Internal Medicine | 18275 N 59th Ave Ste 138, Glendale, AZ 85308-1253 | 2011-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972102572 | Inspire Wellness and Pelvic Health | Clinic/Center | 5940 W Union Hills Dr Ste D280, Glendale, AZ 85308 | 2020-10-23 |
| 1669081709 | Michelle Yoakim | Student in an Organized Health Care Education/Training Program | 19555 N 59th Avenuue, Glendale, AZ 85308 | 2020-07-24 |
| 1033742291 | Kaitlyn Marie Shannon | Dietitian, Registered | 20325 North 51st Avenue, Building 9, Suite 166, Glendale, AZ 85308 | 2020-02-17 |
| 1295377687 | Serenity Preserved Counseling Pllc | Counselor | 21448 N. 75th Avenue Ste G, Glendale, AZ 85308 | 2019-10-17 |
| 1013567023 | Caitlyn Heredia | Student in an Organized Health Care Education/Training Program | 18330 N 79th Avenue, Apartment 1070, Glendale, AZ 85308 | 2019-09-12 |
| 1770141061 | Sydney Dangelo | Student in an Organized Health Care Education/Training Program | 7454 W Denaro Dr, Glendale, AZ 85308 | 2019-05-31 |
| 1023585742 | Center for Couples Therapy, Pllc | Counselor | 18205 N 51st Ave, Ste 113, Glendale, AZ 85308 | 2018-10-31 |
| 1831678341 | Ayat Mahdi Obeidi | Dentist | 19420 N 59th Ave Ste D400, Glendale, AZ 85308 | 2018-08-07 |
| 1720580038 | Lifeline Professional Counseling Services, Inc | Clinic/Center | 17235 N 75th Ave Suite F-100, Glendale, AZ 85308 | 2018-03-02 |
| 1003318585 | Danna Mavis Constance Moisii | Physician Assistant | 18301 N. 79th Ave #g190, Glendale, AZ 85308 | 2018-03-01 |
| Find all providers in zip 85308 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003445768 | Anna Manukyan | Nurse Practitioner | 814 E Broadway Ste 1, Glendale, CA 91205-4552 | 2020-04-05 |
| 1689225427 | Robert Wayne Baker | Nurse Practitioner | 1236 E Harvard St, Glendale, CA 91205-1412 | 2019-09-23 |
| 1548785728 | Evette Facey | Nurse Practitioner | 6506 Myrtle Ave, Glendale, NY 11385-6250 | 2017-08-08 |
| 1619498128 | Anna Krakowski | Nurse Practitioner | 7137 70th St # C, Glendale, NY 11385-7245 | 2017-07-05 |
| 1023567435 | Victoria Bowers | Nurse Practitioner | 6808 N Dysart Rd Ste 136, Glendale, AZ 85307-2232 | 2016-09-26 |
| 1437474129 | Paula Kay Scoggins | Nurse Practitioner | 4221 W Villa Rita Dr, Glendale, AZ 85308-2514 | 2010-04-06 |
| 1205398120 | Christy L Hogue | Nurse Practitioner | 6677 W Thunderbird Rd Ste E, Glendale, AZ 85306-3722 | 2019-04-01 |
| 1518494020 | John Edgar Alan Hammonds | Nurse Practitioner | 5620 W Thunderbird Rd Ste F1, Glendale, AZ 85306-4652 | 2017-05-15 |
| 1750820478 | Mns Medical Group | Nurse Practitioner | 1110 Sonora Ave, Glendale, CA 91201-1952 | 2017-02-14 |
| 1558717314 | Jasmine Petrosyan | Nurse Practitioner | 519 E Broadway, Glendale, CA 91205-1110 | 2016-05-11 |
| Find all providers in GLENDALE | ||||
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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.