MEDICARE: WELL-KONNECT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QA0005X	Ambulatory Family Planning Facility
2	261QC1500X	Community Health Clinic/Center
3	261QR1100X	Research Clinic/Center
4	251E00000X	Home Health Agency
5	251300000X	Local Education Agency (LEA)
6	251F00000X	Home Infusion Agency
7	253Z00000X	In Home Supportive Care Agency
8	163WW0101X	Ambulatory Women's Health Care Registered Nurse
9	251G00000X	Community Based Hospice Care Agency
10	163WC1500X	Community Health Registered Nurse
11	251T00000X	PACE Provider Organization
12	261Q00000X	Clinic/Center
13	261QH0100X	Health Service Clinic/Center
14	261QP2300X	Primary Care Clinic/Center
15	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124748025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELL-KONNECT LLC

Provider Business Mailing Address
First Line	:	3030 30TH ST SE APT 301
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-1657
Country	:	US
Telephone Number	:	240-620-1587
Fax Number	:

Provider Business Practice Location Address
First Line	:	3030 30TH ST SE APT 301
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-1657
Country	:	US
Telephone Number	:	240-620-1587
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KAWANA JEFFER WILLIAMS
Credential	:	NP, PH.D.
Telephone Number	:	240-620-1587

Provider Enumeration Date	:	08/31/2022
Last Update Date	:	06/10/2026

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Directions to “WELL-KONNECT LLC ” Practice Location

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