NPIMap

Organization Active NPI

Wellstreet of Georgia PC

  • Non-Pharmacy Dispensing Site
  • Monroe, GA
National Provider Identifier
1194571026
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
WELLSTREET OF GEORGIA PC
Practice address
850 Pavillion Pkwy
Monroe, GA 30656-5012
Phone
(678) 395-0010
Fax
(678) 395-0020
NPI assigned
Apr 30, 2024
Last updated
Apr 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Katie Mons
Title
District Manager
Phone
(770) 502-2121

Specialties & licenses 1

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

Addresses

Primary practice location

850 Pavillion Pkwy
Monroe, GA 30656-5012

Mailing address

850 Pavillion Pkwy
Monroe, GA 30656-5012
Phone (678) 395-0010

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmons@wellstreet.com

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 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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": "1714435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1194571026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 PAVILLION PKWY",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306565012",
            "telephone_number": "678-395-0010",
            "fax_number": "678-395-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 PAVILLION PKWY",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306565012",
            "telephone_number": "678-395-0010",
            "fax_number": "678-395-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTREET OF GEORGIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "MONS",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "DISTRICT MANAGER",
        "authorized_official_telephone_number": "770-502-2121"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmons@wellstreet.com",
            "affiliation": "N",
            "address_1": "850 Pavillion Pkwy",
            "city": "Monroe",
            "state": "GA",
            "country_code": "US",
            "postal_code": "306565012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.