DIVINE MEDICAL WELLNESS CENTER INC
NPI 1972920098
General Practice in Fresno, CA
About Divine Medical Wellness Center Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DIVINE MEDICAL WELLNESS CENTER INC (NPI 1972920098), doing business as Divine Medical Wellness Center, is a healthcare organization registered as a general practice in Fresno, California and active in the NPI registry since March 2014. The organization lists Randall Lynn Roulund, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Divine Medical Wellness Center Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Divine Medical Wellness Center Inc, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Divine Medical Wellness Center Inc's NPI number?
The NPI number for Divine Medical Wellness Center Inc is 1972920098. It was assigned to this organization in the NPPES registry on March 26, 2014. The provider was formerly known as Divine Medical Wellness Center.
Where is Divine Medical Wellness Center Inc located?
Divine Medical Wellness Center Inc is located at 5150 N 6th St Ste 100, Fresno, CA 93710. The listed phone number is (559) 222-5362.
What is Divine Medical Wellness Center Inc's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Divine Medical Wellness Center Inc enrolled in Medicare?
Yes. Divine Medical Wellness Center Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Divine Medical Wellness Center Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Divine Medical Wellness Center Inc, in Chiropractic, Family Practice and Nurse Practitioner. 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. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Divine Medical Wellness Center Inc was last updated on March 26, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Divine Medical Wellness Center Inc · NPI 1972920098
General Practice organization in Fresno, California. Organization record, active in the CMS NPPES registry since March 26, 2014.
## Identity
- **NPI:** 1972920098 (Entity type: Organization)
- **Enumerated:** March 26, 2014
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **Organization subpart:** No
- **Authorized official:** Randall Roulund, PRESIDENT
## Practice location
- **Address:** 5150 N 6TH ST STE 100, Fresno, CA 93710-7505
- **Phone:** (559) 222-5362
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Chiropractic (2), Family Practice (1), Nurse Practitioner (1); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 26, 2014
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Source: [NPI Profile](https://npiprofile.com/npi/1972920098) · Data from the CMS NPPES public registry.