| Wellness Healthcare Clinics, Llc | |
|
4660 Martin Luther King Jr Ave Sw Ste A2 Washington DC 20032-4933 | |
| (202) 318-0179 | |
| Not Available |
| Full Name | Wellness Healthcare Clinics, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4660 Martin Luther King Jr Ave Sw Ste A2, Washington, District Of Columbia |
| Authorized Official Name and Position | Kimberly Mason (CEO) |
| Authorized Official Contact | 2023180179 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness Healthcare Clinics, Llc 4660 Martin Luther King Jr Ave Sw Ste A1 Washington DC 20032-4958 Ph: (202) 318-0179 | Wellness Healthcare Clinics, Llc 4660 Martin Luther King Jr Ave Sw Ste A2 Washington DC 20032-4933 Ph: (202) 318-0179 |
| NPI Number | 1417432733 |
|---|---|
| Provider Enumeration Date | 10/02/2018 |
| Last Update Date | 03/09/2023 |
| Certification Date | 03/09/2023 |
| Medicare PECOS PAC ID | 1759794423 |
|---|---|
| Medicare Enrollment ID | O20210120000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417432733 | NPI | - | NPPES |
| 032323822 | Medicaid | DC | |
| 033102624 | Medicaid | DC |
| Provider Name | Kean Go Baxter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831543719 PECOS PAC ID: 3779848882 Enrollment ID: I20180521000229 |
| Provider Name | Wilhem Rivera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699062612 PECOS PAC ID: 1153672761 Enrollment ID: I20180920002496 |
| Provider Name | Jean Marc Nken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972072775 PECOS PAC ID: 5597005355 Enrollment ID: I20190314001639 |
| Provider Name | Thickness Patrick Egwuatu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053997122 PECOS PAC ID: 8628474871 Enrollment ID: I20210914000371 |
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