BALANCED WELLNESS PRIMARY CARE, LLC
NPI 1780926774
Nurse Practitioner - Family in Uncasville, CT
About Balanced Wellness Primary Care, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BALANCED WELLNESS PRIMARY CARE, LLC (NPI 1780926774) is a healthcare organization registered as a family in Uncasville, Connecticut and active in the NPI registry since March 2013. The organization holds a CLIA Waiver certificate valid through May 20, 2027 and lists Kristin Marie Mahan, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Balanced Wellness Primary Care, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Balanced Wellness Primary Care, LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 07D2059302
Balanced Wellness Primary Care, LLC · Uncasville, CTFrequently 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 Balanced Wellness Primary Care, LLC's NPI number?
The NPI number for Balanced Wellness Primary Care, LLC is 1780926774. It was assigned to this organization in the NPPES registry on March 18, 2013.
Where is Balanced Wellness Primary Care, LLC located?
Balanced Wellness Primary Care, LLC is located at 620 Norwich New London Tpke, Uncasville, CT 06382. The listed phone number is (860) 892-8012.
What is Balanced Wellness Primary Care, LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Balanced Wellness Primary Care, LLC enrolled in Medicare?
Yes. Balanced Wellness Primary Care, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Balanced Wellness Primary Care, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Balanced Wellness Primary Care, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5) and Physical Medicine and Rehabilitation (1). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Balanced Wellness Primary Care, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 07D2059302) is associated with this NPI, valid through May 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Balanced Wellness Primary Care, LLC accept?
Health plans from Anthem Blue Cross and Blue Shield list Balanced Wellness Primary Care, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Balanced Wellness Primary Care, LLC was last updated on June 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Balanced Wellness Primary Care, Llc · NPI 1780926774
Family organization in Uncasville, Connecticut. Organization record, active in the CMS NPPES registry since March 18, 2013.
## Identity
- **NPI:** 1780926774 (Entity type: Organization)
- **Enumerated:** March 18, 2013
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Kristin Mahan, OWNER
## Practice location
- **Address:** 620 NORWICH NEW LONDON TPKE, Uncasville, CT 06382
- **Phone:** (860) 892-8012 · **Fax:** (860) 892-8027
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Physical Medicine and Rehabilitation (1); 4 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 17, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1780926774) · Data from the CMS NPPES public registry.