Organization Active NPI

Walk in Wellness LLC

  • Recovery Care Clinic/Center
  • Gordon, GA
National Provider Identifier
1740025246
Registry record updated Jun 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Recovery Care Clinic/CenterTaxonomy code 261QR0800X
Legal business name
WALK IN WELLNESS LLC
Practice address
111 Epps St
Gordon, GA 31031-3805
Phone
(678) 437-1388
NPI assigned
Jun 26, 2024
Last updated
Jun 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2024

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

Authorized official

Name
Louise Clark-Dickes
Title
Business Development Officer
Phone
(973) 666-2926

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X
Recovery Care Clinic/Center 261QR0800X Primary
Non-emergency Medical Transport (VAN) 343900000X
Community/Behavioral Health Agency 251S00000X
Supports Brokerage Agency 251X00000X

Addresses

Primary practice location

111 Epps St
Gordon, GA 31031-3805

Mailing address

75 Washington St Unit 383
Fairburn, GA 30213-3604
Phone (973) 666-2926

National Provider Directory

National Provider Directory

Locations

75 Washington St
Unit 383
Fairburn, GA 30213

111 Epps St
Gordon, GA 31031
Phone (478) 628-1126

NPI Registry JSON

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719619200000",
    "number": "1740025246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 WASHINGTON ST UNIT 383",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302133604",
            "telephone_number": "973-666-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 EPPS ST",
            "city": "GORDON",
            "state": "GA",
            "postal_code": "310313805",
            "telephone_number": "678-437-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALK IN WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-29",
        "certification_date": "2024-06-29",
        "status": "A",
        "authorized_official_last_name": "CLARK-DICKES",
        "authorized_official_first_name": "LOUISE",
        "authorized_official_title_or_position": "BUSINESS DEVELOPMENT OFFICER",
        "authorized_official_telephone_number": "973-666-2926"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gordon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2024; 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.