Premier Wellness Solutions, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PREMIER WELLNESS SOLUTIONS, LLC

Practice address

1841 Montreal Rd Ste 110
Tucker, GA 30084-5713

Phone

(404) 735-0857

NPI assigned

Nov 21, 2019

Organization subpart

No

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

Authorized official

Name

Matthew Underwood, DPTNPI 1992165260

Title

Owner and Clinic Director

Phone

(404) 735-0857

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• The Atlanta Back Clinic and Orthopedic Physical Therapy Doing business as

Practitioners 1

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

• Matthew Adrian Underwood, PT, DPT

  • Physical Therapist
  • Duluth, GA
  • NPI 1992165260
  NPD Authorized official

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574294400000",
    "number": "1255977435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 BROOK PARK WAY",
            "city": "DORAVILLE",
            "state": "GA",
            "postal_code": "303401810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 MONTREAL RD STE 110",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845713",
            "telephone_number": "404-735-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER WELLNESS SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-21",
        "last_updated": "2019-11-21",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER AND CLINIC DIRECTOR",
        "authorized_official_telephone_number": "404-735-0857",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1104014125",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1740478734",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1366630345",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Atlanta Back Clinic and Orthopedic Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen Poynor, LPC, NCC
• Karissa NA'Shea Prater, LCSW
• Derrick Jones Prejean, RBT
• Gia Prelli, M.A., CCC-SLP
• Premier Family Healthcare, P.C.
• Premiere International Health Care Inc.
• Bruce Alan Preston, D.M.D
• Latoya Preston, CDM,CFPP
• Price and Wood Opticians Inc
• Brianna Price

• Physical Therapy Clinic/Center in Tucker, GA
• Providers in Tucker, GA by specialty
• Physical Therapy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; 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.