| Trinity Wellness Center Of Wilmington Inc | |
|
1907 S 17th St Suite 1 Wilmington NC 28401-6626 | |
| (910) 343-8424 | |
| (910) 343-6989 |
| Full Name | Trinity Wellness Center Of Wilmington Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1907 S 17th St, Wilmington, North Carolina |
| Authorized Official Name and Position | Marisa Martell (CREDENTIALLING MANAGER) |
| Authorized Official Contact | 9044207343 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trinity Wellness Center Of Wilmington Inc 1907 S 17th St Suite 1 Wilmington NC 28401-6626 Ph: (910) 343-8424 | Trinity Wellness Center Of Wilmington Inc 1907 S 17th St Suite 1 Wilmington NC 28401-6626 Ph: (910) 343-8424 |
| NPI Number | 1841382173 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 06/04/2024 |
| Certification Date | 06/04/2024 |
| Medicare PECOS PAC ID | 6002843752 |
|---|---|
| Medicare Enrollment ID | O20050725000425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841382173 | NPI | - | NPPES |
| 6005578 | Medicaid | NC | |
| 5900768 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 9600112 (North Carolina) | Primary |
| Provider Name | Patricia A Odham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750457024 PECOS PAC ID: 9234237801 Enrollment ID: I20071109000131 |
| Provider Name | Kimberly Adams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093875338 PECOS PAC ID: 8123008059 Enrollment ID: I20080514000369 |
| Provider Name | Rano T Mathew |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972694297 PECOS PAC ID: 6002883865 Enrollment ID: I20100428000911 |
| Provider Name | Pamela J Wenning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902021769 PECOS PAC ID: 1850472531 Enrollment ID: I20110303000529 |
| Provider Name | Jeanne L Amerine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528423456 PECOS PAC ID: 2163700519 Enrollment ID: I20161107000033 |
| Provider Name | Jennah Cutting |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184161622 PECOS PAC ID: 6103157086 Enrollment ID: I20191007003180 |
| Provider Name | Susan E Gell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609526821 PECOS PAC ID: 0143607267 Enrollment ID: I20220511001387 |
| Provider Name | Lauren Morton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871220442 PECOS PAC ID: 5799161782 Enrollment ID: I20220928001851 |
| Provider Name | Tailar Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073143756 PECOS PAC ID: 7315376720 Enrollment ID: I20231005003820 |
| Provider Name | Shawna Leigh White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134841992 PECOS PAC ID: 1759737299 Enrollment ID: I20231019002494 |
| Provider Name | Kristen Ann Mingia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962134783 PECOS PAC ID: 3072969211 Enrollment ID: I20231025001083 |
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