NPIMap

Organization Active NPI

Wellstreet of Georgia PC

Doing business as Piedmont Urgent Care by Wellstreet

  • Non-Pharmacy Dispensing Site
  • Macon, GA
National Provider Identifier
1699419432
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
WELLSTREET OF GEORGIA PC
Doing business as
Piedmont Urgent Care by Wellstreet
Practice address
2410 Ingleside Ave
Macon, GA 31204-2036
Phone
(478) 309-1004
Fax
(478) 309-2396
NPI assigned
Apr 27, 2022
Last updated
Apr 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Authorized official

Name
Katie Cassarino
Title
Practice Manager
Phone
(678) 414-2824

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

2410 Ingleside Ave
Macon, GA 31204-2036

Mailing address

2410 Ingleside Ave
Macon, GA 31204-2036
Phone (478) 309-1004

Other names 1

  • Piedmont Urgent Care by Wellstreet Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcassarino@wellstreet.com

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2103029Piedmont Urgent Care by Wellstreet2410 Ingleside Ave, Macon, GA 31204Certificate of waiverMay 24, 2028

National Provider Directory

National Provider Directory
Tax ID family
Wellstreet of Georgia PC93 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1699419432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 INGLESIDE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312042036",
            "telephone_number": "478-309-1004",
            "fax_number": "478-309-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 INGLESIDE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312042036",
            "telephone_number": "478-309-1004",
            "fax_number": "478-309-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTREET OF GEORGIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "CASSARINO",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "678-414-2824"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcassarino@wellstreet.com",
            "affiliation": "N",
            "address_1": "2410 Ingleside Ave",
            "city": "Macon",
            "state": "GA",
            "country_code": "US",
            "postal_code": "312042036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Piedmont Urgent Care by Wellstreet",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.