NPI Code Detail JSON Logo

1700746005 NPI number — AFYAGM HEALTH & WELLNESS LLC

NPI Number: 1700746005
Health Care Provider/Practitioner: AFYAGM HEALTH & WELLNESS LLC

Information about “1700746005” NPI (AFYAGM HEALTH & WELLNESS LLC) exists in 1700746005 in HTML format HTML  |  1700746005 in plain Text format TXT  |  1700746005 in PDF (Portable Document Format) PDF  |  1700746005 in an XML format XML  formats.

NPI Number : 1700746005 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700746005",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "AFYAGM HEALTH & WELLNESS LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "8919 BROOKSIDE AVE STE 105",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WEST CHESTER",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "45069-7109",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "513-214-0315",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "8919 BROOKSIDE AVE STE 105",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WEST CHESTER",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "45069-7109",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "513-214-0315",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/18/2025",
    "LastUpdateDate": "11/22/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SMALL",
    "AuthorizedOfficialFirstName": "TAMARA",
    "AuthorizedOfficialMiddleName": "FELICE",
    "AuthorizedOfficialTitle": "CEO/PROVIDER",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PHD, APRN, FNP-C",
    "AuthorizedOfficialTelephoneNumber": "513-417-0320",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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