Personal Wellness Inc.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

PERSONAL WELLNESS INC.

Practice address

625 Boxwood Ter
Johns Creek, GA 30005-7217

Phone

(770) 569-9429

NPI assigned

Jul 26, 2018

Organization subpart

No

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

Authorized official

Name

Mr. David Robert Rich

Title

Ceo

Phone

(770) 569-9429

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 2

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

• Kenneth Macleod Rice, M.D.

  • Emergency Medicine Physician
  • Cumming, GA
  • NPI 1831148063

  Multi-Specialty

  Medicare reassignment NPD
• Brandy Brown, DNP,APRN, FNP-C, PMH

  • Nurse Practitioner
  • Snellville, GA
  • NPI 1003252412
  Medicare reassignment

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532563200000",
    "number": "1780161323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 BOXWOOD TER",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300057217",
            "telephone_number": "770-569-9429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 BOXWOOD TER",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300057217",
            "telephone_number": "770-569-9429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL WELLNESS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-569-9429",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Dentistry of Johns Creek, LLC
• Per Badilika
• Mario Perazza, D.C.
• Canelda Tashay Perry, FNP-C
• Personal Recovery Network LLC
• Personic Ga PC
• Sanjit D Peter, M.D.
• Vy Vy Ann Thi Pham
• Huu Phan, PA-C
• Julie Phan

• Adult Medicine Physician in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Adult Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.