Living Well Primary Care, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LIVING WELL PRIMARY CARE, LLC

Practice address

12460 Crabapple Rd Ste 202-313
Alpharetta, GA 30004-6602

Phone

(404) 819-7660

Fax

(404) 393-7788

NPI assigned

Jul 6, 2022

Last updated

Jul 6, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Lee Pennington McNichols, NP

Title

Owner/Managing Member

Phone

(404) 819-7660

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1013640242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12460 CRABAPPLE RD STE 202-313",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300046602",
            "telephone_number": "404-819-7660",
            "fax_number": "404-393-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12460 CRABAPPLE RD STE 202-313",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300046602",
            "telephone_number": "404-819-7660",
            "fax_number": "404-393-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "MCNICHOLS",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "PENNINGTON",
        "authorized_official_title_or_position": "OWNER/MANAGING MEMBER",
        "authorized_official_telephone_number": "404-819-7660",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Alpharetta, GA
• Providers in Alpharetta, 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 Jul 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.