BALANCED WELLNESS PRIMARY CARE, LLC
NPI 1780926774
Nurse Practitioner - Family in Uncasville, CT
NPI Status: Active since March 18, 2013
Contact Information
620 NORWICH NEW LONDON TPKE
UNCASVILLE, CT
ZIP 06382
Phone: (860) 892-8012
Fax: (860) 892-8027
- Organization
- Nurse Practitioner
- Family
- CLIA Number: 07D2059302
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 05-20-2027
About BALANCED WELLNESS PRIMARY CARE, LLC
This page provides the complete NPI Profile along with additional information for Balanced Wellness Primary Care, Llc, a provider established in Uncasville, Connecticut operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1780926774 assigned on March 2013. The practitioner's primary taxonomy code is 363LF0000X with license number 004797 (CT). The provider is registered as an organization and their NPI record was last updated 4 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Kristin Marie Mahan (Owner)
- NPI
- 1780926774
- Provider Name
- BALANCED WELLNESS PRIMARY CARE, LLC
- Entity Type
- Organization
- Location Address
- 620 NORWICH NEW LONDON TPKE UNCASVILLE, CT 06382
- Location Phone
- (860) 892-8012
- Location Fax
- (860) 892-8027
- Mailing Address
- 620 NORWICH NEW LONDON TPKE UNCASVILLE, CT 06382
- Mailing Phone
- (860) 892-8012
- Mailing Fax
- (860) 892-8027
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-18-2013
- Last Update Date
- 06-17-2022
- Code Navigator
A nurse practitioner (NP) like Balanced Wellness Primary Care, Llc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 004797
- License State
- CT
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 07D2059302
- Facility Type
- Practitioner Other
- Certificate Effective Date
- May 21, 2025
- Certificate Expiration Date
- May 20, 2027
- Laboratory Director
- KRISTIN M. MAHAN APRN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Balanced Wellness Primary Care, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1780926774, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 66 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 10 providers are registered at the same or a nearby location.
UNCASVILLE, CT 06382
UNCASVILLE, CT 06382
UNCASVILLE, CT 06382
UNCASVILLE, CT 06382
UNCASVILLE, CT 06382
UNCASVILLE, CT 06382
UNCASVILLE, CT 06382
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1780926774, enumerated as an "organization" on March 18, 2013.
The provider is located at 620 NORWICH NEW LONDON TPKE UNCASVILLE, CT 06382 and the phone number is (860) 892-8012.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
