Organization Active NPI

A Family Practice and Wellness Center

  • Exclusive Provider Organization
  • Cartersville, GA
National Provider Identifier
1184896573
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 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
Last updated
Dec 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

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

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764547200000",
    "number": "1184896573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E MAIN ST",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301203335",
            "telephone_number": "770-386-5262",
            "fax_number": "770-386-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E MAIN ST",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301203335",
            "telephone_number": "770-386-5262",
            "fax_number": "770-386-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A FAMILY PRACTICE AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A",
        "authorized_official_last_name": "CRUMP",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PATIENT CARE COORDINATOR",
        "authorized_official_telephone_number": "770-386-5262",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.