Bwell Medical and Wellness Center

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

BWELL MEDICAL AND WELLNESS CENTER

Practice address

5933 Stewart Pkwy
Douglasville, GA 30135-2371

Phone

(470) 331-9468

Fax

(770) 234-5717

NPI assigned

Feb 12, 2021

Last updated

May 24, 2021By 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

Vivian Adu-Aboagye, NURSE PRACTITIONERNPI 1043798838

Title

Administrator

Phone

(470) 331-9468

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24304/brand/1/csg/1/fhir/r4

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.

• Vivian Adu-Aboagye

  • Family Nurse Practitioner
  • Lithia Springs, GA
  • NPI 1043798838

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1093308918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5933 STEWART PKWY",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352371",
            "telephone_number": "470-331-9468",
            "fax_number": "770-234-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5933 STEWART PKWY",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352371",
            "telephone_number": "470-331-9468",
            "fax_number": "770-234-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BWELL MEDICAL AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-12",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "ADU-ABOAGYE",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "470-331-9468",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelvin B. Burton, M.D.
• Brittany Bush
• Awais Ijaz Butt, D.C.
• Aundrea Hammock Butts, LPC
• Bwell Integrative Health and Wellness Center LLC
• Natalie Phuong Byrne, AGACNP-BC
• C E Mitchell Services Foundation
• C&C Healthcare Services Inc
• C&E Medical Supplies
• Jessica Kristin Cabrera, MS, NCC

• Family Nurse Practitioner in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.