Organization Active NPI

Wilson's Wellness Clinical Care, LLC

  • Primary Care Clinic/Center
  • Stone Mountain, GA
National Provider Identifier
1073041166
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
WILSON'S WELLNESS CLINICAL CARE, LLC
Practice address
1310 Rockbridge Rd Ste F
Stone Mountain, GA 30087-3163
Phone
(770) 864-5538
Fax
(404) 393-4038
NPI assigned
Jun 1, 2017
Last updated
Oct 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Authorized official

Name
Dr. Dana Wilson, FNPNPI 1518383959
Title
Owner/Manager
Phone
(404) 981-3936

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1310 Rockbridge Rd Ste F
Stone Mountain, GA 30087-3163

Mailing address

1310 Rockbridge Rd Ste F
Stone Mountain, GA 30087-3163
Phone (770) 864-5538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171016000915 GA Part B Supplier - Clinic/Group Practice 0941576136 Receives reassigned benefits from 1 practitioner
Practice locations: Stone Mountain, GA

National Provider Directory

National Provider Directory

Locations

1525 E Park Place Blvd
Stone Mountain, GA 30087
Phone (404) 981-3936

1310 Rockbridge Rd
Ste F
Stone Mtn, GA 30087
Phone (770) 864-5538

1525 E Park Place Blvd
Ste 300
Stone Mtn, GA 30087
Phone (404) 981-3936

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1073041166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 ROCKBRIDGE RD STE F",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873163",
            "telephone_number": "770-864-5538",
            "fax_number": "404-393-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 ROCKBRIDGE RD STE F",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873163",
            "telephone_number": "770-864-5538",
            "fax_number": "404-393-4038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON'S WELLNESS CLINICAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-01",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "404-981-3936",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.