Organization Active NPI

Legacy Wellness Group Inc.

Doing business as BrightStar Care of Locust Grove & McDonough

  • Home Health Agency
  • McDonough, GA
National Provider Identifier
1063389815
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LEGACY WELLNESS GROUP INC.
Doing business as
BrightStar Care of Locust Grove & McDonough
Practice address
1525 Pennsylvania Ave
McDonough, GA 30253-9114
Phone
(678) 827-4678
Fax
(678) 827-4677
NPI assigned
Oct 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Authorized official

Name
Dwayne Booker II
Title
Ceo
Phone
(678) 641-5395

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1525 Pennsylvania Ave
McDonough, GA 30253-9114

Mailing address

1525 Pennsylvania Ave
McDonough, GA 30253-9114
Phone (678) 827-4678

Other names 1

  • BrightStar Care of Locust Grove & McDonough Doing business as

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
11D2335444Brightstar Care Locust Grove & McDonough1525 Pennsylvania Avenue, McDonough, GA 30253Certificate of waiverDec 10, 2027

National Provider Directory

National Provider Directory

Locations

1525 Pennsylvania Ave
McDonough, GA 30253
Phone (678) 827-4678

NPI Registry JSON

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

{
    "created_epoch": "1760659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760659200000",
    "number": "1063389815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 PENNSYLVANIA AVE",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302539114",
            "telephone_number": "678-827-4678",
            "fax_number": "678-827-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 PENNSYLVANIA AVE",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302539114",
            "telephone_number": "678-827-4678",
            "fax_number": "678-827-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY WELLNESS GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-17",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A",
        "authorized_official_last_name": "BOOKER",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-641-5395",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BrightStar Care of Locust Grove & McDonough",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; 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.