Organization Active NPI

Dynamic Wellness Wound LLC

  • Nurse Practitioner
  • Hiawassee, GA
National Provider Identifier
1457237240
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
DYNAMIC WELLNESS WOUND LLC
Practice address
150 S Main St Ste B
Hiawassee, GA 30546-3453
Phone
(833) 221-4169
NPI assigned
Aug 15, 2025
Last updated
Jan 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Authorized official

Name
Kristina Bryant
Title
President
Phone
(833) 221-4169

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

150 S Main St Ste B
Hiawassee, GA 30546-3453

Mailing address

150 S Main St Ste B
Hiawassee, GA 30546-3453
Phone (833) 221-4169

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251014000779 GA Part B Supplier - Clinic/Group Practice 2769979889 Receives reassigned benefits from 2 practitioners
Practice locations: Hiawassee, GA

National Provider Directory

National Provider Directory

Locations

150 S Main St
Ste B
Hiawassee, GA 30546
Phone (706) 963-3053

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768348800000",
    "number": "1457237240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S MAIN ST STE B",
            "city": "HIAWASSEE",
            "state": "GA",
            "postal_code": "305463453",
            "telephone_number": "833-221-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S MAIN ST STE B",
            "city": "HIAWASSEE",
            "state": "GA",
            "postal_code": "305463453",
            "telephone_number": "833-221-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC WELLNESS WOUND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-15",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "833-221-4169"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiawassee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; 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.