Addiction Wellness Center in LLC
NPI 1720703382ActiveOrganization· Nurse Practitioner· Jeffersonville, IN
Nurse Practitioner in Jeffersonville, Indiana, registered in NPPES in October 2022. The authorized official on file is Jessie Costley, Credentialing Specialist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1720703382 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 6, 2022 |
| Last updated in NPPES | Feb 28, 2025 |
| Certified by provider | Feb 28, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
| Nurse Practitioner, Adult Health | 363LA2200X | — | — |
| Nurse Practitioner, Family | 363LF0000X | — | — |
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 (IN) |
|---|
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