NPIMap

Organization Active NPI

Wellstreet of Georgia PC

Doing business as Piedmont Urgent Care by Wellstreet

  • Non-Pharmacy Dispensing Site
  • Carrollton, GA
National Provider Identifier
1174104574
Registry record updated Apr 16, 2021
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 Urgent Care by Wellstreet
Practice address
909 S Park St
Carrollton, GA 30117-4456
Phone
(678) 782-9994
NPI assigned
Apr 16, 2021
Last updated
Apr 16, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
WELLSTREET OF GEORGIA PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Authorized official

Name
Katie Cassarino
Title
Practice Manager
Phone
(470) 400-3449

Specialties & licenses 1

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

Addresses

Primary practice location

909 S Park St
Carrollton, GA 30117-4456

Mailing address

3350 Riverwood Pkwy SE Ste 1850
Atlanta, GA 30339-3300

Other names 1

  • Piedmont Urgent Care by Wellstreet Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Kcassarino@wellstreet.com

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
11D2169181Piedmont Urgent Care by Wellstreet909 South Park Street, Carrollton, GA 30117Certificate of waiverJul 16, 2027

National Provider Directory

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

Organizations with this tax ID in the same state 24

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

View all 24

Locations

909 S Park St
Carrollton, GA 30117
Phone (678) 782-9994

NPI Registry JSON

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1174104574",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 S PARK ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174456",
            "telephone_number": "678-782-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTREET OF GEORGIA PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLSTREET OF GEORGIA PC",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "CASSARINO",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "470-400-3449"
    },
    "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": "Kcassarino@wellstreet.com",
            "affiliation": "N",
            "address_1": "909 S Park St",
            "city": "Carrollton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301174456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Piedmont Urgent Care by Wellstreet",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.