Organization Active NPI

Easy Care Wellness LLC

  • Primary Care Nurse Practitioner
  • Watkinsville, GA
National Provider Identifier
1417751306
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
EASY CARE WELLNESS LLC
Practice address
1050 Barber Creek Dr BLDG 100
Ste 103
Watkinsville, GA 30677-4502
Phone
(706) 850-0170
Fax
(888) 355-5361
NPI assigned
Apr 1, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Authorized official

Name
Chaquita Thomas, NPNPI 1609293463
Title
Owner
Phone
(334) 380-1888

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
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

1050 Barber Creek Dr BLDG 100
Ste 103
Watkinsville, GA 30677-4502

Mailing address

132 Red Maple Dr
Athens, GA 30606-0886
Phone (334) 380-1888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250409001195 GA Part B Supplier - Clinic/Group Practice 3072037241 Receives reassigned benefits from 1 practitioner
Practice locations: Watkinsville, GA

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
11D2323791Easy Care Wellness LLC1050 Barber Creek Drive, BLDG 100, Suite 103, Watkinsville, GA 30677Certificate of waiverMay 13, 2027

National Provider Directory

National Provider Directory

Locations

1050 Barber Creek Dr
Ste 100
Watkinsville, GA 30677

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": "1743465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1417751306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 RED MAPLE DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306060886",
            "telephone_number": "334-380-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 BARBER CREEK DR BLDG 100",
            "address_2": "STE 103",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306774502",
            "telephone_number": "706-850-0170",
            "fax_number": "888-355-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASY CARE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "CHAQUITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-380-1888",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.