CENTER STATE WELLNESS LLC (NPI# 1689235319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689235319 |
| Entity Type | Organization |
| Organization Name | CENTER STATE WELLNESS LLC |
| Practice Address |
102 Pleasant St Concord NH 03301-3863 |
| Practice Telephone | 6035567101 |
| Practice Fax Number | 9494046458 |
| Mailing Telephone | 6035567101 |
| Mailing Fax Number | 9494046458 |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2019-06-24 |
| Authorized Official Name | MR. RUSSELL HOWARD (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 6035567101 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 26 Water St, Keene, NH 034314235 | 6035567101 |
| Street Address |
102 PLEASANT ST |
| City | CONCORD |
| State | NH |
| Zip Code | 03301-3863 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689661381 | Sreemali Vasantha | Dentist | 102 Pleasant St, Suite # 3, Concord, NH 03301-3831 | 2005-09-29 |
| 1659932879 | Ramona Smith | Social Worker | 102 Pleasant St, Concord, NH 03301-3863 | 2019-06-27 |
| 1144889130 | Lifeworks Counseling Associates Pllc | Counselor | 102 Pleasant St, Concord, NH 03301-3863 | 2019-06-12 |
| 1043690498 | Rachel Ann Giguere | Dental Hygienist | 102 Pleasant St, Concord, NH 03301-3863 | 2015-06-01 |
| 1174919302 | Odessa Jane Becker | Dental Hygienist | 102 Pleasant St, Suite 3, Concord, NH 03301-3863 | 2015-04-14 |
| 1164852125 | Advantage Foot Care | Podiatrist | 102 Pleasant St, Concord, NH 03301-3831 | 2013-11-12 |
| 1497197024 | White Park Dental Pllc | Dentist | 102 Pleasant St, Suite#3, Concord, NH 03301-3831 | 2013-07-24 |
| 1730441445 | Amanda Kathleen Hegnauer | Naturopath | 102 Pleasant St, Suite 1, Concord, NH 03301-3863 | 2012-06-10 |
| 1790061026 | Affiliates In Podiatry, PC | Podiatrist | 102 Pleasant St, Concord, NH 03301 | 2011-11-01 |
| 1710295894 | Elizabeth Johnston Dennis | Dietitian, Registered | 102 Pleasant St, Ste 2, Concord, NH 03301-3863 | 2010-09-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154988483 | Kelly Jean O'brien | Dental Hygienist | Nhti-concord's Community College, 31 College Drive, Concord, NH 03301 | 2019-05-22 |
| 1437640679 | Kyle Moore Thorne | Nurse Anesthetist, Certified Registered | 1 Pillsbury St Ste 202, Concord, NH 03301 | 2018-05-23 |
| 1730688789 | Ashley M Pinkham | Nurse Practitioner | 246 Pleasant St Ste 104, Concord, NH 03301 | 2018-02-06 |
| 1134645831 | D & B Medical Logistics LLC | Non-emergency Medical Transport (VAN) | 119 Old Turnpike Rd, Concord, NH 03301 | 2017-08-15 |
| 1821520727 | Julie Haejung Chang | Dentist | 273 Loudon Rd, Concord, NH 03301 | 2017-03-30 |
| 1407396500 | Oakmont Med Solutions | Durable Medical Equipment & Medical Supplies | 14 Centre Street, Concord, NH 03301 | 2017-03-08 |
| 1407210347 | Sherri Jean Perry | Nurse Practitioner | Medoptions Behavioral Health Services, 10 Ferry Street, Suite 313, Concord, NH 03301 | 2016-04-06 |
| 1922474428 | Optometric Associates of Nh, LLC | Optometrist | 273 Loudon Road, Suite 7, Concord, NH 03301 | 2015-08-19 |
| 1871969600 | Creative Counseling Center, Pllc | Counselor | 18 Kennedy Lane, Concord, NH 03301 | 2015-08-16 |
| 1376927087 | Families In Transition | Counselor | 9 Odd Fellows Ave, Concord, NH 03301 | 2015-07-13 |
| Find all providers in zip 03301 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164041927 | Kayla Norman | Nurse Practitioner | 827 Gaulding Rd, Concord, GA 30206-2258 | 2020-04-13 |
| 1982246534 | Josephine Akih Ojong Fongoh | Nurse Practitioner | 7395 Millstone Cir Sw, Concord, NC 28025-0005 | 2019-10-16 |
| 1356995187 | Lyndsey Michele Vallee | Nurse Practitioner | 10 Ferry St Ste 201, Concord, NH 03301-5081 | 2019-07-30 |
| 1215580923 | Zoe J. Owers | Nurse Practitioner | 248 Pleasant St Ste 2600, Concord, NH 03301-7529 | 2019-07-22 |
| 1659834984 | Alisha Hudson Eudy | Nurse Practitioner | 2934 Walter Dr Nw, Concord, NC 28027-5562 | 2019-04-12 |
| 1831674647 | Rebecca C Diamond | Nurse Practitioner | 24 Bridge St Ste 9, Concord, NH 03301-4922 | 2018-09-27 |
| 1730688789 | Ashley M Pinkham | Nurse Practitioner | 246 Pleasant St Ste 104, Concord, NH 03301 | 2018-02-06 |
| 1295272565 | Jasmin Moultrie | Nurse Practitioner | 2095 Diamond Blvd, Concord, CA 94520-5832 | 2017-01-25 |
| 1417406976 | Lena Lax | Nurse Practitioner | 185 Central St, Concord, MA 01742-2909 | 2016-09-26 |
| 1760834857 | Sheri N. Davis | Nurse Practitioner | 11005 Heber Springs Rd N, Concord, AR 72523-9561 | 2016-07-13 |
| Find all providers in CONCORD | ||||
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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.