Lucent Integrative Wellness

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

LUCENT INTEGRATIVE WELLNESS

Practice address

1097 Greensboro Rd Ste 102
Eatonton, GA 31024-9510

Phone

(706) 997-7266

NPI assigned

Sep 24, 2024

Last updated

Sep 24, 2024By 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

Dr. Ursula F. Waller, DNAP, CRNANPI 1679986988

Title

Owner

Phone

(706) 997-7266

Specialties & licenses 1

Addresses

Locations

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.

• Ursula F Waller

  • Certified Registered Nurse Anesthetist
  • Buckhead, GA
  • NPI 1679986988
  NPD Authorized official

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1104643782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 MARSHALL RD",
            "city": "BUCKHEAD",
            "state": "GA",
            "postal_code": "306252906",
            "telephone_number": "706-997-7266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1097 GREENSBORO RD STE 102",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310249510",
            "telephone_number": "706-997-7266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCENT INTEGRATIVE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "URSULA",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-997-7266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNAP, CRNA"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Deanna Lester, OTR
• Chelsea Lewis, FNP-C
• Rebecca Ann Little, LDO
• Rulanda Mathis Little
• Donald Douglas Lowe, LAT, ATC
• Linda Marie M Cummings
• Magnolia Medical Group, LLC
• Marquesia Trion Mathis
• Kira Cheryle McCarthy, HOLISTIC
• Rebecca McMichael, RDMS

• Health Service Clinic/Center in Eatonton, GA
• Providers in Eatonton, GA by specialty
• Health Service Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.