Whole Self Wellness, Llc is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Oakdale, Connecticut. The current practice location for Whole Self Wellness, Llc is 627 Norwich Salem Tpke Unit 2, Oakdale, Connecticut. For appointments, you can reach them via phone at
(860) 222-0949. The mailing address for Whole Self Wellness, Llc is 627 Norwich Salem Tpke Unit 2, Oakdale, Connecticut and phone number is (860) 222-0949.
Whole Self Wellness, Llc is licensed to practice in Connecticut (license number 004768). The clinic also participates in the medicare program and its
NPI number is 1588114870. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(860) 222-0949.
Primary Care Clinic Profile
| Full Name | Whole Self Wellness, Llc |
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| Speciality | Clinic/Center |
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| Location | 627 Norwich Salem Tpke Unit 2, Oakdale, Connecticut |
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| Authorized Official Name and Position | Andrea Stephanie Dameron (APRN/OWNER) |
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| Authorized Official Contact | 8602220949 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Whole Self Wellness, Llc
627 Norwich Salem Tpke Unit 2
Oakdale
CT 06370-1066
Ph: (860) 222-0949 | Whole Self Wellness, Llc
627 Norwich Salem Tpke Unit 2
Oakdale
CT 06370-1066
Ph: (860) 222-0949 |
NPI Details:
| NPI Number | 1588114870 |
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| Provider Enumeration Date | 10/11/2016 |
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| Last Update Date | 12/02/2020 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 1850673559 |
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| Medicare Enrollment ID | O20170112001502 |
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Medical Identifiers
Medical identifiers for Whole Self Wellness, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1588114870 | NPI | - | NPPES |
| 1356624027 | Other | CT | NPI |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 261QP2300X | Clinic/center - Primary Care | 004768 (Connecticut) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Whole Self Wellness, Llc acts as a billing entity for following providers:
| Provider Name | Andrea S Dameron |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1356624027
PECOS PAC ID: 4981879640
Enrollment ID: I20111207000413 |
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