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NURSE MANAGED WELLNESS CLINIC
NPI 1013463561
Nurse Practitioner - Family in Cumberland, MD

Active since August 25, 2016CLIA 21D2093034 · Waiver
12401 WILLOWBROOK RD, CUMBERLAND, MD 21502(301) 784-5670(301) 784-5093 Get Directions Write a Review

NPPES record last updated: April 28, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 28, 2017, Apr 18, 2017, Aug 25, 2016 (3 updates tracked since 2016).

About Nurse Managed Wellness Clinic NPPES

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

NURSE MANAGED WELLNESS CLINIC (NPI 1013463561) is a healthcare organization registered as a family in Cumberland, Maryland and active in the NPI registry since August 2016. The organization holds a CLIA Waiver certificate valid through March 18, 2027 and lists Anna Kephart, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1013463561
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameALLEGANY COLLEGE OF MARYLAND
Location Address12401 WILLOWBROOK RDCumberland, MD 21502-2559
Mailing Address12401 Willowbrook RdCumberland, MD 21502-2559 · (301) 784-5670 · Fax (301) 784-5093
Phone(301) 784-5670
Fax(301) 784-5093
Organization SubpartNo
Authorized OfficialAnna KephartOffice Manager · (301) 784-5670
Enumeration DateAugust 25, 2016
Last NPPES UpdateApril 28, 20173 updates tracked since enumeration
✔ NPI 1013463561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in MD · R081546✔ Licensed in MD · R095433
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X · License 21D2093034 (MD)
12401 WILLOWBROOK RD, Cumberland, MD 21502
Open in Google Maps ↗

Other Names 1

Doing Business AsNurse Managed Wellness Clinic

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 21D2093034

Nurse Managed Wellness Center · Cumberland, MD
Active · expires Mar 18, 2027
CLIA Number21D2093034
Laboratory TypeSchool/Student Health Service
Certificate Effective DateMarch 19, 2025
Certificate Expiration DateMarch 18, 2027
Laboratory DirectorTracie L. Koontz
Laboratory Phone(301) 784-5548
Laboratory LocationNurse Managed Wellness Center12401 Willowbrook Rd, SE Allied Hlth Bldg, Rm 122 Allegany College Of Maryland, Cumberland, MD 21502
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

MRS. BRENDA LEE OWENS FNP-BC
Nurse Practitioner (Family)
12401 WILLOWBROOK RD
CUMBERLAND, MD 21502
Allegany County (301) 784-5670
ALLEGANY COLLEGE OF MARYLAND
Nurse Practitioner (Family)
12401 WILLOWBROOK RD, ALLIED HEALTH BUILDING, ROOM 115
CUMBERLAND, MD 21502
Allegany County (301) 784-5670
DR. JAMES LEANDER HILGEMAN DDS
Dentist (General Practice)
12401 WILLOWBROOK RD
CUMBERLAND, MD 21502
Allegany County (301) 784-5540
MICHELE C COSNER WHNP
Registered Nurse
12401 WILLOWBROOK RD
CUMBERLAND, MD 21502
Allegany County (301) 784-5670

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 Allegany College Of Maryland's NPI number?

The NPI number for Allegany College Of Maryland is 1013463561. It was assigned to this organization in the NPPES registry on August 25, 2016. The provider is doing business as Nurse Managed Wellness Clinic.

Where is Allegany College Of Maryland located?

Allegany College Of Maryland is located at 12401 Willowbrook Rd, Cumberland, MD 21502. The listed phone number is (301) 784-5670.

What is Allegany College Of Maryland's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Allegany College Of Maryland hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2093034) is associated with this NPI, valid through March 18, 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 Allegany College Of Maryland was last updated on April 28, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.