Organization Active NPI

Simple Faith Wellness LLC

  • Registered Dietitian
  • Lawrenceville, GA
National Provider Identifier
1205769965
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
SIMPLE FAITH WELLNESS LLC
Practice address
1711 Watford GLN
Lawrenceville, GA 30043-3078
Phone
(757) 652-6488
NPI assigned
Jun 3, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Authorized official

Name
Kesha Chanel Palmer, LDNPI 1003748047
Title
Licensed Dietitian
Phone
(757) 652-6488

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

1711 Watford GLN
Lawrenceville, GA 30043-3078

Mailing address

2296 Henderson Mill Rd NE Ste 116
Atlanta, GA 30345-2739
Phone (757) 652-6488

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1780444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1205769965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2296 HENDERSON MILL RD NE STE 116",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452739",
            "telephone_number": "757-652-6488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 WATFORD GLN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300433078",
            "telephone_number": "757-652-6488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLE FAITH WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-03",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "KESHA",
        "authorized_official_middle_name": "CHANEL",
        "authorized_official_title_or_position": "LICENSED DIETITIAN",
        "authorized_official_telephone_number": "757-652-6488",
        "authorized_official_credential": "LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.