Wisteria Wellness Center, Inc.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

WISTERIA WELLNESS CENTER, INC.

Practice address

2336 Wisteria Dr Ste 410
Snellville, GA 30078-6160

Phone

(770) 979-0074

Fax

(770) 979-8305

NPI assigned

Jan 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Flora Denise Cox, M.D.

Title

Medical Director

Phone

(770) 979-0074

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ganiat Jaiyesinmi Ajayi, MD

  • Neurology Physician
  • Winder, GA
  • NPI 1023170842
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669522959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2336 WISTERIA DR STE 410",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786160",
            "telephone_number": "770-979-0074",
            "fax_number": "770-979-8305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2336 WISTERIA DR STE 410",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786160",
            "telephone_number": "770-979-0074",
            "fax_number": "770-979-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISTERIA WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "FLORA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-979-0074",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeff P Winemiller, RPH
• Samuel Awuah Winful, NP
• Anthony Wingfield, RBT
• Wisdom Center
• Wise Ride Transportation LLC
• Reginald Witherspoon
• Katherine Woitalla, RBT
• Women of Truth Inc
• Women'S Group of Gwinnett 2 LLC
• Yemisrach Wondimu, BCBA

• Psychiatry Physician in Snellville, GA
• Providers in Snellville, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.