Organization Active NPI

Evolutio Wellness LLC

  • Nurse Practitioner
  • Stockbridge, GA
National Provider Identifier
1487522546
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
EVOLUTIO WELLNESS LLC
Practice address
1325 Rock Quarry Rd Ste 100
Stockbridge, GA 30281-5029
Phone
(770) 389-0566
NPI assigned
Oct 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Authorized official

Name
Angelique Young, FNP-C
Title
Owner
Phone
(770) 910-6826

Specialties & licenses 1

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

Addresses

Primary practice location

1325 Rock Quarry Rd Ste 100
Stockbridge, GA 30281-5029

Mailing address

160 Glen Eagle Way
McDonough, GA 30253-4227
Phone (770) 910-6826

National Provider Directory

National Provider Directory

Locations

1325 Rock Quarry Rd
Ste 100
Stockbridge, GA 30281
Phone (770) 389-0566

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": "1761696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1487522546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 GLEN EAGLE WAY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534227",
            "telephone_number": "770-910-6826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 ROCK QUARRY RD STE 100",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815029",
            "telephone_number": "770-389-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTIO WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-28",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "ANGELIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-910-6826",
        "authorized_official_credential": "FNP-C"
    },
    "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 Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.