Organization Active NPI

Heal Well Healthcare Solutions, LLC

  • Family Nurse Practitioner
  • Woodstock, GA
National Provider Identifier
1417770926
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
HEAL WELL HEALTHCARE SOLUTIONS, LLC
Practice address
6478 Putnam Ford Dr Ste 105
Woodstock, GA 30189-6988
Phone
(770) 599-5127
NPI assigned
Nov 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
Alisa McCall Jackson, FNP-CNPI 1255946133
Title
Manager/Co-Owner
Phone
(770) 599-5127

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
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

6478 Putnam Ford Dr Ste 105
Woodstock, GA 30189-6988

Mailing address

6478 Putnam Ford Dr Ste 105
Woodstock, GA 30189-6988
Phone (770) 599-5127

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250306000210 GA Part B Supplier - Clinic/Group Practice 2062933013 Receives reassigned benefits from 2 practitioners
Practice locations: Woodstock, GA

National Provider Directory

National Provider Directory

Locations

6478 Putnam Ford Dr
Ste 105
Woodstock, GA 30189
Phone (770) 599-5127

Practitioners & affiliated clinicians

Practitioners 2

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": "1730678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1417770926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6478 PUTNAM FORD DR STE 105",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301896988",
            "telephone_number": "770-599-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6478 PUTNAM FORD DR STE 105",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301896988",
            "telephone_number": "770-599-5127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAL WELL HEALTHCARE SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ALISA",
        "authorized_official_middle_name": "MCCALL",
        "authorized_official_title_or_position": "MANAGER/CO-OWNER",
        "authorized_official_telephone_number": "770-599-5127",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.