Provider Demographics
NPI:1184435109
Name:YIWELLNESS
Entity type:Organization
Organization Name:YIWELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-754-0980
Mailing Address - Street 1:1194 OLD HENDERSON RD STE A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-3694
Mailing Address - Country:US
Mailing Address - Phone:614-869-0085
Mailing Address - Fax:614-869-0083
Practice Address - Street 1:1194 OLD HENDERSON RD STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-3694
Practice Address - Country:US
Practice Address - Phone:614-869-0085
Practice Address - Fax:614-869-0083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1932429776Medicaid