WELL-CARE CORP (NPI# 1952853061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952853061 |
| Entity Type | Organization |
| Organization Name | WELL-CARE CORP |
| Practice Address |
4215 Dale Blvd Woodbridge VA 22193-2243 |
| Practice Telephone | 5715949110 |
| Practice Fax Number | 5715265509 |
| Mailing Telephone | 5715949110 |
| Mailing Fax Number | 5715265509 |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2016-10-25 |
| Authorized Official Name | CARLOS FAGBENRO (OWNER) |
| Authorized Official Telephone | 5715949110 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024169586 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4215 DALE BLVD |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22193-2243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710353248 | Stella N Kintu | Pharmacist | 4215 Dale Blvd, Tds Health, Woodbridge, VA 22193-2243 | 2015-08-19 |
| 1942821145 | Tds Health Home Care LLC | Home Health Aide | 4215 Dale Blvd, Woodbridge, VA 22193-2243 | 2020-04-29 |
| 1467975565 | Tds Health | Pharmacy | 4215 Dale Blvd, Woodbridge, VA 22193-2243 | 2017-07-20 |
| 1720538754 | All In All Home Care, LLC | Home Health | 4215 Dale Blvd, Woodbridge, VA 22193-2243 | 2016-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083111702 | Bethiana Magallanes White | Speech-Language Pathologist | 14450 Brook Dr, Woodbridge, VA 22193 | 2018-04-09 |
| 1982111449 | Frances Davis | Social Worker | 4196 Merchant Plaza Apt 632, Woodbridge, VA 22193 | 2018-01-05 |
| 1427421627 | Woodbridge Therapy Group LLC | Counselor | 12721 Darby Brooke Ct., Suite 102, Woodbridge, VA 22193 | 2015-11-10 |
| 1972981090 | Lifeline Home Health Inc | Community/Behavioral Health | 4309 Kenwood Dr, Woodbridge, VA 22193 | 2015-05-08 |
| 1588056139 | Lifelong Good Health LLC | Clinic/Center | 5721 Rhode Isalnd Drive, Woodbridge, VA 22193 | 2015-02-19 |
| 1639560378 | Tara Devi Smith | Psychologist | 13855 Hedgewood Drive, #245, Woodbridge, VA 22193 | 2015-02-17 |
| 1710396114 | Allanna Harrison | Speech-Language Pathologist | 15792 Beau Ridge Dr., Woodbridge, VA 22193 | 2014-08-11 |
| 1659788909 | Lifelong Good Health | Clinic/Center | 5721 Rhode Island Dr, Woodbridge, VA 22193 | 2014-07-18 |
| 1952731960 | Corrieann Marie Avila | Social Worker | 12721 Darby Brooke Court, Suite 102, Woodbridge, VA 22193 | 2013-11-13 |
| 1972881019 | Ockhee Jung | Acupuncturist | 14174 Rizdon Ct, Woodbridge, VA 22193 | 2011-07-22 |
| Find all providers in zip 22193 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639797681 | Ruthzie Frazil | Nurse Practitioner | 225 Mawbey St, Woodbridge, NJ 07095-2315 | 2020-07-07 |
| 1275152035 | Jenny Lee Potter | Nurse Practitioner | 14948 Grassy Knoll Ct, Woodbridge, VA 22193-6002 | 2020-04-13 |
| 1346883220 | Sabrina Ann Salem | Nurse Practitioner | 3085 Clarkford Ct, Woodbridge, VA 22192-1107 | 2019-10-23 |
| 1831745264 | Sosina Jules | Nurse Practitioner | 5324 Satterfield Dr, Woodbridge, VA 22193-3408 | 2019-08-12 |
| 1720545452 | Shannon Marie Murley | Nurse Practitioner | 4500 Pond Way Ste 170, Woodbridge, VA 22192-5596 | 2019-02-28 |
| 1134685654 | Mabinti Kamara | Nurse Practitioner | 12770 Ripple Creek Ct Apt 2314, Woodbridge, VA 22192-6562 | 2019-02-20 |
| 1659846566 | Jennifer Couso | Nurse Practitioner | 1000 Route 9 N Ste 302, Woodbridge, NJ 07095-1200 | 2018-10-06 |
| 1467937854 | James Robert Dyson | Nurse Practitioner | 14010 Smoketown Rd # 103, Woodbridge, VA 22192-4722 | 2018-10-01 |
| 1295242469 | Victoria Afi Dzah | Nurse Practitioner | 2573 Grayton Ln, Woodbridge, VA 22191-4786 | 2018-01-09 |
| 1093228363 | Sheryl Cekot | Nurse Practitioner | 102 Cricket Ln, Woodbridge, NJ 07095-1502 | 2017-11-09 |
| Find all providers in WOODBRIDGE | ||||
| City | WOODBRIDGE |
| Zip Code | 22193 |
Please comment or provide details below to improve the information on WELL-CARE CORP.
| 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.