1. Home
  2. Directory
  3. Connecticut
  4. Stamford
  5. Family Medicine
  6. NPI Profile

REVERSE TIME WELLNESS INC
NPI 1003611187
Family Medicine in Stamford, CT

Active since February 13, 2025CLIA 07D2320774 · Waiver
1086 LONG RIDGE RD, STAMFORD, CT 06903(203) 274-7426(203) 274-7426 Get Directions Write a Review

NPPES record last updated: April 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 8, 2025, Feb 13, 2025 (2 updates tracked since 2025).

About Reverse Time Wellness Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVERSE TIME WELLNESS INC (NPI 1003611187) is a healthcare organization registered as a family medicine in Stamford, Connecticut and active in the NPI registry since February 2025. The organization holds a CLIA Waiver certificate valid through March 23, 2027 and lists Neishelle Walcott, President, as its authorized official.

NPPES Registry Identity

NPI1003611187
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameREVERSE TIME WELLNESS INC
Location Address1086 LONG RIDGE RDStamford, CT 06903-4404
Mailing Address1086 Long Ridge RdStamford, CT 06903-4404 · (203) 274-7426 · Fax (203) 274-7426
Phone(203) 274-7426
Fax(203) 274-7426
Organization SubpartNo
Authorized OfficialNeishelle WalcottPresident · (203) 274-7426
Enumeration DateFebruary 13, 2025
Last NPPES UpdateApril 8, 20252 updates tracked since enumeration
NPPES CertifiedApril 8, 2025
✔ NPI 1003611187 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedEmergency Medicine · Emergency Medical ServicesTaxonomy 207PE0004X
1086 LONG RIDGE RD, Stamford, CT 06903
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D2320774

Reverse Time Wellness Inc · Stamford, CT
Active · expires Mar 23, 2027
CLIA Number07D2320774
Laboratory TypePractitioner Other
Certificate Effective DateMarch 24, 2025
Certificate Expiration DateMarch 23, 2027
Laboratory DirectorNeishelle Walcott
Laboratory Phone(917) 773-5270
Laboratory LocationReverse Time Wellness Inc1086 Long Ridge Rd, Stamford, CT 06903
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEISHELLE DIONNE WALCOTT
Physician Assistant
1086 LONG RIDGE RD
STAMFORD, CT 06903
Western Connecticut Planning Region (203) 274-7426

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Reverse Time Wellness Inc's NPI number?

The NPI number for Reverse Time Wellness Inc is 1003611187. It was assigned to this organization in the NPPES registry on February 13, 2025.

Where is Reverse Time Wellness Inc located?

Reverse Time Wellness Inc is located at 1086 Long Ridge Rd, Stamford, CT 06903. The listed phone number is (203) 274-7426.

What is Reverse Time Wellness Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Reverse Time Wellness Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D2320774) is associated with this NPI, valid through March 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Reverse Time Wellness Inc was last updated on April 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.