NPIMap

Organization Active NPI

Wellstreet of Georgia PC

  • Non-Pharmacy Dispensing Site
  • Lawrenceville, GA
National Provider Identifier
1104523661
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
WELLSTREET OF GEORGIA PC
Practice address
1043 Old Peachtree Rd NW
Lawrenceville, GA 30043
Phone
(678) 335-5400
Fax
(678) 335-5401
NPI assigned
Feb 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Authorized official

Name
Katie Mons
Title
Practice Manager
Phone
(678) 414-2824

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

1043 Old Peachtree Rd NW
Lawrenceville, GA 30043

Mailing address

1043 Old Peachtree Rd NW
Lawrenceville, GA 30043
Phone (678) 335-5400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmons@wellstreet.com

National Provider Directory

National Provider Directory
Tax ID family
Wellstreet of Georgia PC93 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

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

View all 22

Locations

1043 Old Peachtree Rd NW
Lawrenceville, GA 30043
Phone (678) 335-5400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676332800000",
    "number": "1104523661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 OLD PEACHTREE RD NW",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30043",
            "telephone_number": "678-335-5400",
            "fax_number": "678-335-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 OLD PEACHTREE RD NW",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30043",
            "telephone_number": "678-335-5400",
            "fax_number": "678-335-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTREET OF GEORGIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "MONS",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "678-414-2824"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmons@wellstreet.com",
            "affiliation": "N",
            "address_1": "1043 Old Peachtree Rd NW",
            "city": "Lawrenceville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.