Coosa Valley Wellness, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

COOSA VALLEY WELLNESS, LLC

Practice address

4451 Alabama Hwy NW Ste 2
Rome, GA 30165-9200

Phone

(904) 302-3202

Fax

(706) 739-7276

NPI assigned

Aug 5, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charlie Campbell

Title

President

Phone

(904) 302-3202

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1003646902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4451 ALABAMA HWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301659200",
            "telephone_number": "904-302-3202",
            "fax_number": "706-739-7276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4451 ALABAMA HWY NW STE 2",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301659200",
            "telephone_number": "904-302-3202",
            "fax_number": "706-739-7276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOSA VALLEY WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "CHARLIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-302-3202"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coosa Neurology PC
• Coosa Neurosurgery PC
• Coosa Procedure Center LLC
• Coosa Valley Chiropractic, LLC
• Coosa Valley Regional Services
• Rose Cope, PTA
• Deanna Barge Cordle, NP-C
• Emma Cordle, NP
• Emmett Price Cordle, M.D.
• Leone P Cordle, PA-C

• Primary Care Clinic/Center in Rome, GA
• Providers in Rome, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.