NPIMap

Organization Active NPI

Wellstreet of Georgia PC

  • Non-Pharmacy Dispensing Site
  • Lagrange, GA
National Provider Identifier
1366023764
Registry record updated Apr 16, 2021
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
1524 Lafayette Pkwy
Lagrange, GA 30241-2566
Phone
(706) 530-2151
NPI assigned
Apr 16, 2021
Organization subpart
Yes
Parent organization
WELLSTREET OF GEORGIA PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Authorized official

Name
Katie Cassarino
Title
Practice Manager
Phone
(470) 400-3449

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

1524 Lafayette Pkwy
Lagrange, GA 30241-2566

Mailing address

3350 Riverwood Pkwy SE Ste 1850
Atlanta, GA 30339-3300

Other names 1

  • Piedmont Urgent Care by Wellstreet Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Kcassarino@wellstreet.com

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
11D2165501Piedmont Urgent Care by Wellstreet1524 Lafayette Parkway, Lagrange, GA 30241Certificate of waiverApr 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Wellstreet of Georgia PC93 organizations share this tax ID, including this one
Part of
Wellstreet of Georgia PC

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

NPI Registry JSON

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1366023764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 RIVERWOOD PKWY SE STE 1850",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 LAFAYETTE PKWY",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302412566",
            "telephone_number": "706-530-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTREET OF GEORGIA PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLSTREET OF GEORGIA PC",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "CASSARINO",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "470-400-3449"
    },
    "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": "Kcassarino@wellstreet.com",
            "affiliation": "N",
            "address_1": "1524 Lafayette Pkwy",
            "city": "LaGrange",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302412566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Piedmont Urgent Care by Wellstreet",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.