NPIMap

Organization Active NPI

Wellstreet of Georgia PC

Doing business as Piedmont Urgentcare of Wellstreet

  • Non-Pharmacy Dispensing Site
  • Atlanta, GA
National Provider Identifier
1124532916
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
WELLSTREET OF GEORGIA PC
Doing business as
Piedmont Urgentcare of Wellstreet
Practice address
3617 Roswell Rd NE Ste a
Atlanta, GA 30305-1111
Phone
(770) 809-3036
NPI assigned
Dec 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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

Authorized official

Name
Brandy Carter
Title
Director
Phone
(404) 996-0344

Specialties & licenses 1

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

Addresses

Primary practice location

3617 Roswell Rd NE Ste a
Atlanta, GA 30305-1111

Mailing address

3350 Riverwood Pkwy SE Ste 1850
Atlanta, GA 30339-3300
Phone (770) 809-3036

Other identifiers 1

IdentifierTypeStateIssuer
003136510AMedicaidGA

Other names 1

  • Piedmont Urgentcare of Wellstreet Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2039989Piedmont Urgentcare by Wellstreet3617 Roswell Road, Suite a, Atlanta, GA 30305Certificate of waiverApr 19, 2028

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512086400000",
    "number": "1124532916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 RIVERWOOD PKWY SE STE 1850",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393300",
            "telephone_number": "770-809-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 ROSWELL RD NE STE A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051111",
            "telephone_number": "770-809-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTREET OF GEORGIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-01",
        "last_updated": "2017-12-01",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "404-996-0344"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136510A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piedmont Urgentcare of Wellstreet",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.