Wellstreet of Georgia PC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

WELLSTREET OF GEORGIA PC

Doing business as

Piedmont Urgentcare by Wellstreet

Practice address

921 Eagles Landing Pkwy
Stockbridge, GA 30281-5011

Phone

(770) 692-5910

NPI assigned

Apr 25, 2018

Organization subpart

No

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

Authorized official

Name

Tonia Rana Davis

Title

Credentialing Corrdinator

Phone

(770) 809-3036

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Piedmont Urgentcare by Wellstreet Doing business as

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

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nnenna Egbuna, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Lithonia, GA
  • NPI 1215440136
  NPD (past)
• Shaye Elizabeth Rawson, PA-C

  • Physician Assistant
  • East Point, GA
  • NPI 1093374381
  NPD (past)
• Kaitlin M Schafer, PA-C

  • Physician Assistant
  • Berwyn, PA
  • NPI 1639534142
  NPD (past)

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574121600000",
    "number": "1730677816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 RIVERWOOD PKWY SE STE 1850",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815011",
            "telephone_number": "770-692-5910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2084 Newnan Crossing Blvd E",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302652398",
            "country_code": "US",
            "telephone_number": "678-695-6960",
            "fax_number": "678-695-6960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "907 S Park St",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "GA",
            "postal_code": "301174455",
            "country_code": "US",
            "telephone_number": "678-782-9994",
            "fax_number": "678-782-9994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Line Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302691028",
            "country_code": "US",
            "telephone_number": "770-847-8786",
            "fax_number": "770-892-5824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3120 Johnson Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300625657",
            "country_code": "US",
            "telephone_number": "770-835-4741",
            "fax_number": "678-401-4660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3515 Camp Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "East Point",
            "state": "GA",
            "postal_code": "30344",
            "country_code": "US",
            "telephone_number": "404-344-7337",
            "fax_number": "404-344-8338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1524 Lafayette Pkwy",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "GA",
            "postal_code": "302412566",
            "country_code": "US",
            "telephone_number": "706-530-2151",
            "fax_number": "706-530-2151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1825 Highway 34 E Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302656416",
            "country_code": "US",
            "telephone_number": "770-502-2121",
            "fax_number": "770-502-2113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "749 Lanier Ave W",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302147658",
            "country_code": "US",
            "telephone_number": "770-835-4925",
            "fax_number": "770-629-6709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "549 Bullsboro Dr",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302651045",
            "country_code": "US",
            "telephone_number": "770-683-3180",
            "fax_number": "770-683-3181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLSTREET OF GEORGIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-25",
        "last_updated": "2019-11-19",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "TONIA",
        "authorized_official_middle_name": "RANA",
        "authorized_official_title_or_position": "CREDENTIALING CORRDINATOR",
        "authorized_official_telephone_number": "770-809-3036"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003177641A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piedmont Urgentcare by Wellstreet",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vanessa Renee Webb, CSFA
• Tina Fabayo Webster
• Wee Care Assisting Living
• Courtney Spillane Weeks, PA
• Tierra Simone Wells, DNP, FNP-C, PMHNP-BC
• Angela Westbrook
• Julie K Whitdford
• Tonetta White Atley, CCMA,CPT
• Diamond White
• Kimberly Denise White, PHARMD

• Non-Pharmacy Dispensing Site in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Non-Pharmacy Dispensing Site in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.