NPIMap

Organization Active NPI

Wellstreet of Georgia PC

  • Non-Pharmacy Dispensing Site
  • Canton, GA
National Provider Identifier
1740924489
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
Practice address
2026 Cumming Hwy Ste 100
Canton, GA 30115-8011
Phone
(470) 541-2255
Fax
(470) 398-3181
NPI assigned
Apr 27, 2022
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

2026 Cumming Hwy Ste 100
Canton, GA 30115-8011

Mailing address

2026 Cumming Hwy Ste 100
Canton, GA 30115-8011
Phone (470) 541-2255

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
11D2240149Piedmont Urgent Care by Wellstreet2026 Cumming Highway, Canton, GA 30115Certificate of waiverOct 17, 2027

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

Locations

2026 Cumming Hwy
Ste 100
Canton, GA 30115
Phone (470) 541-2255

Practitioners & affiliated clinicians

Practitioners 1

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

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": "1740924489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 CUMMING HWY STE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158011",
            "telephone_number": "470-541-2255",
            "fax_number": "470-398-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 CUMMING HWY STE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158011",
            "telephone_number": "470-541-2255",
            "fax_number": "470-398-3181"
        }
    ],
    "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": "2026 Cumming Hwy Ste 100",
            "city": "Canton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301158011",
            "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 Canton, 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.