Organization Active NPI

Tia Health and Wellness Center LLC

  • Clinic/Center
  • Kennesaw, GA
National Provider Identifier
1245029859
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
TIA HEALTH AND WELLNESS CENTER LLC
Practice address
3772 Cherokee St NW
Kennesaw, GA 30144-2080
Phone
(770) 562-7948
NPI assigned
May 1, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Mrs. Althea A Bryan, NURSE PRACTITIONERNPI 1518564418
Title
Ceo
Phone
(770) 562-7948

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

3772 Cherokee St NW
Kennesaw, GA 30144-2080

Mailing address

198 Rotherhithe LN NW
Marietta, GA 30066-3491
Phone (770) 562-7948

Other names 1

  • Tia Hydrate Doing business as

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
11D2266101Tia Health and Wellness Center LLC3772 Cherokee Street, Kennesaw, GA 30144Certificate of waiverAug 4, 2026

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": "1746057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1245029859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 ROTHERHITHE LN NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300663491",
            "telephone_number": "770-562-7948",
            "fax_number": "770-691-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3772 CHEROKEE ST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442080",
            "telephone_number": "770-562-7948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIA HEALTH AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "BRYAN",
        "authorized_official_first_name": "ALTHEA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-562-7948",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tia Hydrate",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; 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.