Active NPI
Evolutio Wellness LLC
- Nurse Practitioner
- Stockbridge, GA
National Provider Identifier
1487522546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 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 DirectoryLocations
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.
-
- Internal Medicine Physician
- Stockbridge, GA
- NPI 1104925106
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.