NPIMap

Organization Active NPI

Wellstreet of Georgia PC

  • Urgent Care Clinic/Center
  • Cumming, GA
National Provider Identifier
1316515141
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
WELLSTREET OF GEORGIA PC
Practice address
880 Buford Hwy
Cumming, GA 30041
Phone
(770) 292-9982
NPI assigned
Jun 17, 2021
Last updated
Apr 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Heather Brock
Title
Credentialing Supervisor
Phone
(678) 770-9005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

880 Buford Hwy
Cumming, GA 30041

Mailing address

1825 Highway 34 E Ste 1200
Newnan, GA 30265-6416
Phone (470) 851-3353

Other practice location 1

7820 Hickory Flat Hwy
Woodstock, GA 30188-2099
Phone (678) 672-5100

Other practice location 2

285 Ridgewalk Pkwy Ste 108
Woodstock, GA 30188-4964
Phone (404) 382-9890

Other practice location 3

789 Church St NE
Marietta, GA 30060-7237
Phone (404) 382-9890

Other practice location 4

2021 Market Place Blvd
Cumming, GA 30041-7931
Phone (770) 292-9982

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

Locations

789 Church St NE
Marietta, GA 30060
Phone (404) 382-9890

285 Ridgewalk Pkwy
Ste 108
Woodstock, GA 30188
Phone (404) 382-9890

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1316515141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 HIGHWAY 34 E STE 1200",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302656416",
            "telephone_number": "470-851-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 BUFORD HWY",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "770-292-9982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7820 Hickory Flat Hwy",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "GA",
            "postal_code": "301882099",
            "country_code": "US",
            "telephone_number": "678-672-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "285 Ridgewalk Pkwy Ste 108",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "GA",
            "postal_code": "301884964",
            "country_code": "US",
            "telephone_number": "404-382-9890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "789 Church St NE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300607237",
            "country_code": "US",
            "telephone_number": "404-382-9890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2021 Market Place Blvd",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300417931",
            "country_code": "US",
            "telephone_number": "770-292-9982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLSTREET OF GEORGIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-17",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "BROCK",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "678-770-9005"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.