Peachtree Total Wellness LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

PEACHTREE TOTAL WELLNESS LLC

Practice address

100 Governors Trce Ste 108
Peachtree City, GA 30269-4853

Phone

(817) 966-2764

NPI assigned

Jan 5, 2022

Organization subpart

No

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

Authorized official

Name

Terri Edwards

Title

VP of Revenue Strategy

Phone

(817) 966-2764

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1023779733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10019 REISTERSTOWN RD FL 3",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173902",
            "telephone_number": "817-966-2764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GOVERNORS TRCE STE 108",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694853",
            "telephone_number": "817-966-2764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE TOTAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2021-12-29",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "VP OF REVENUE STRATEGY",
        "authorized_official_telephone_number": "817-966-2764"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rebekah Kay Pearson, PT, DPT
• William Kevin Pearson, DPM
• Kaila Peat
• Pediatrics Village, P.C.

• Substance Use Disorder Rehabilitation Clinic/Center in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.