Organization Active NPI

Wellspring

  • Psychiatric Residential Treatment Facility
  • Gainesville, FL
National Provider Identifier
1558767970
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
ME0037298 Issued in FL
Legal business name
WELLSPRING
Practice address
5618 NW 43Rd Street
Gainesville, FL 32653
Phone
(352) 377-8770
Fax
(352) 371-3623
NPI assigned
Nov 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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

Authorized official

Name
George Randall Williams, MD
Title
Owner
Phone
(352) 377-8770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X ME0037298 FL Primary

Addresses

Primary practice location

5618 NW 43Rd Street
Gainesville, FL 32653

Mailing address

5618 NW 43Rd Street
Gainesville, FL 32653
Phone (352) 377-8770

National Provider Directory

National Provider Directory

Locations

5618 NW 43rd St
Gainesville, FL 32653
Phone (352) 377-5374

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": "1415750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415923200000",
    "number": "1558767970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5618 NW 43RD STREET",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32653",
            "telephone_number": "352-377-8770",
            "fax_number": "352-371-3623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5618 NW 43RD STREET",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32653",
            "telephone_number": "352-377-8770",
            "fax_number": "352-371-3623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-12",
        "last_updated": "2014-11-14",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "RANDALL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-377-8770",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "FL",
            "license": "ME0037298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; 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.