A Family Practice and Wellness Center

Organization Active NPI Exclusive Provider Organization · Cartersville, GA

NPI 1184896573 · NPPES record last updated Dec 1, 2025

Key facts

NPI
1184896573
Entity type
Organization (NPI type 2)
Primary specialty
Exclusive Provider Organization 302F00000X
Legal business name
A FAMILY PRACTICE AND WELLNESS CENTER
Practice address
309 E Main St
Cartersville, GA 30120-3335
Phone
(770) 386-5262
Fax
(770) 386-0502
NPI assigned
Mar 26, 2008
Organization subpart
No

Authorized official

Name
Mrs. Ashley R Crump
Title
Patient Care Coordinator
Phone
(770) 386-5262

Practitioners 9

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080516000124 GA Part B Supplier - Clinic/Group Practice 8820167802 Receives reassigned benefits from 2 practitioners
Practice locations: Cartersville, GA

National Provider Directory

Locations

309 E Main St
Cartersville, GA 30120
Phone (770) 386-5262

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X Yes

Addresses

Primary practice location

309 E Main St
Cartersville, GA 30120-3335

Mailing address

309 E Main St
Cartersville, GA 30120-3335
Phone (770) 386-5262

Other providers in Cartersville, GA

All providers in Cartersville, GA · Exclusive Provider Organization in Georgia

Sources for this page

Verify at the official NPI Registry.