Wellness Legacy LLC
NPI 1134777576ActiveOrganization· Nurse Practitioner· Bel Air, MD
Nurse Practitioner in Bel Air, Maryland, registered in NPPES in August 2019. The authorized official on file is Mark Ison, CRNP, Co-Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1134777576 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 28, 2019 |
| Last updated in NPPES | Mar 27, 2024 |
| Certified by provider | Mar 27, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
| Nurse Practitioner, Family | 363LF0000X | — | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MD) |
|---|
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