OrganizationActive
Fusion of Wellness: Body, Mind, and Soul, LLC.
NPI 1922503465 · Primary Care Clinic/Center · Georgetown, IL
Provider details
- NPI number
- 1922503465
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Fabienne Witherspoon, Owner/Nurse Practitioner(217) 274-6966
- License
- 209009867 (IL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
712 N Main St
Georgetown, IL 61846-1440
Phone: (217) 274-6966
Street-level locationGet directions
Mailing address
712 N Main St
Georgetown, IL 61846-1440
Registry dates
- Enumerated
- 2018-03-27
- Last updated
- 2018-05-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.