Active NPI
Wellness One of Suwanee
- Family Medicine Physician
- Suwanee, GA
National Provider Identifier
1124243704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 042114
- Legal business name
- WELLNESS ONE OF SUWANEE
- Practice address
- 1500 Peachtree Industrial Blvd
Suite 290
Suwanee, GA 30024 - Phone
- (678) 482-7375
- NPI assigned
- Apr 17, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Daniel Lynn Middleton
- Title
- Billing Manager
- Phone
- (770) 850-0857
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIRO008139 | GA | |
| Family Medicine Physician | 207Q00000X | 052963 | GA | |
| Family Medicine Physician | 207Q00000X | 042114 | GA | Primary |
Addresses
Primary practice location
1500 Peachtree Industrial Blvd
Suite 290
Suwanee, GA 30024
Mailing address
PO Box 672641
Marietta, GA 30006-2641
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1124243704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 672641",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300062641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 PEACHTREE INDUSTRIAL BLVD",
"address_2": "SUITE 290",
"city": "SUWANEE",
"state": "GA",
"postal_code": "30024",
"telephone_number": "678-482-7375"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLNESS ONE OF SUWANEE",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-17",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "MIDDLETON",
"authorized_official_first_name": "DANIEL",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "770-850-0857",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIRO008139",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "GA",
"license": "052963",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "GA",
"license": "042114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Suwanee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.