NPIMap

Organization Active NPI

Premise Health of Georgia Medical, P.C.

Doing business as The Wellness Center Operated by Premise Health Marietta South

  • Multi-Specialty Clinic/Center
  • Marietta, GA
National Provider Identifier
1619750387
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PREMISE HEALTH OF GEORGIA MEDICAL, P.C.
Doing business as
The Wellness Center Operated by Premise Health Marietta South
Practice address
86 South Cobb Drive Mail Drop 0603
Marietta, GA 30063-0001
Phone
(770) 494-3423
Fax
(770) 793-4685
NPI assigned
Aug 16, 2023
Last updated
Aug 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Authorized official

Name
Will Wright
Title
Legal Counsel
Phone
(615) 577-5893

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

86 South Cobb Drive Mail Drop 0603
Marietta, GA 30063-0001

Mailing address

5500 Maryland Way Ste 120
Brentwood, TN 37027-4993

Other names 1

  • The Wellness Center Operated by Premise Health Marietta South Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of Georgia Medical PC50 organizations share this tax ID, including this one

Other organizations with this tax ID 49

Organizations that report the same tax identification number in the National Provider Directory.

View all 49

Locations

86 S Cobb Dr SE
#603
Marietta, GA 30063
Phone (770) 494-3423

NPI Registry JSON

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1619750387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY STE 120",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 SOUTH COBB DRIVE MAIL DROP 0603",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300630001",
            "telephone_number": "770-494-3423",
            "fax_number": "770-793-4685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF GEORGIA MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "WILL",
        "authorized_official_title_or_position": "LEGAL COUNSEL",
        "authorized_official_telephone_number": "615-577-5893"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Wellness Center Operated by Premise Health Marietta South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.