NPIMap

Organization Active NPI

Wellstreet of Georgia PC

  • Non-Pharmacy Dispensing Site
  • Streetsboro, OH
National Provider Identifier
1316728629
Registry record updated Jan 16, 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
9449 State Route 14
Streetsboro, OH 44241-5225
Phone
(330) 227-8640
Fax
(330) 426-8701
NPI assigned
Oct 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 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 Primary

Addresses

Primary practice location

9449 State Route 14
Streetsboro, OH 44241-5225

Mailing address

9449 State Route 14
Streetsboro, OH 44241-5225
Phone (330) 227-8640

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmons@wellstreet.com

National Provider Directory

National Provider Directory
Tax ID family
Wellstreet of Georgia PC22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Locations

9449 State Route 14
Streetsboro, OH 44241
Phone (330) 227-6640

NPI Registry JSON

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1316728629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9449 STATE ROUTE 14",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415225",
            "telephone_number": "330-227-8640",
            "fax_number": "330-426-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9449 STATE ROUTE 14",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415225",
            "telephone_number": "330-227-8640",
            "fax_number": "330-426-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTREET OF GEORGIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-12",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmons@wellstreet.com",
            "affiliation": "N",
            "address_1": "9449 State Route 14",
            "city": "Streetsboro",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442415225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Streetsboro, OH

Sources for this page

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