NPIMap

Organization Active NPI

Healthstat on-Site Clinic/Milliken Kingsley

  • Nurse Practitioner
  • Thomson, GA
National Provider Identifier
1043645914
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
HEALTHSTAT ON-SITE CLINIC/MILLIKEN KINGSLEY
Practice address
2598 Washington Rd
Thomson, GA 30824-6651
Phone
(706) 880-3120
NPI assigned
Sep 10, 2013
Last updated
Apr 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Authorized official

Name
Jeff Wells, MD
Title
President
Phone
(317) 985-2111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

2598 Washington Rd
Thomson, GA 30824-6651

Mailing address

PO Box 1433
Portsmouth, NH 03802-1433

Other names 1

  • Milliken - Kingsley Health Center Other name

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1103686Healthstat on Site Clinic Milliken Kingsley2598 Washington Road, Thomson, GA 30824Certificate of waiverAug 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Healthstat Onsite Clinic Parkdale Plant 16237 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

2598 Washington Rd
Thomson, GA 30824
Phone (706) 880-3120

NPI Registry JSON

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776816000000",
    "number": "1043645914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1433",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038021433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2598 WASHINGTON RD",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308246651",
            "telephone_number": "706-880-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSTAT ON-SITE CLINIC/MILLIKEN KINGSLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-10",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-985-2111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Milliken - Kingsley Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Thomson, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.