Wellstreet of Georgia PC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

WELLSTREET OF GEORGIA PC

Practice address

1155 Concord Rd SE Ste 200
Smyrna, GA 30080-4207

Phone

(770) 809-3036

Fax

(404) 662-2399

NPI assigned

Dec 4, 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 Coordinator

Phone

(770) 809-3036

Specialties & licenses 2

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

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

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573603200000",
    "number": "1891265773",
    "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",
            "telephone_number": "770-809-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 CONCORD RD SE STE 200",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804207",
            "telephone_number": "770-809-3036",
            "fax_number": "404-662-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTREET OF GEORGIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-04",
        "last_updated": "2019-11-13",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "TONIA",
        "authorized_official_middle_name": "RANA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "770-809-3036"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003137211A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piedmont Urgentcare by Wellstreet",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Piedmont Urgentcare by Wellstreet",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wellstar Medical Group, LLC
• Wellstar Medical Group, LLC
• Wellstar Rheumatology, LLC
• Wellstar Smyrna Primary Care Center, LLC
• Wellstreet of Georgia PC
• Frederick P Wener, MD
• Samantha Nicole Werkheiser, PA-C
• West Atlanta OB-GYN Inc
• West Atlanta Women'S Health, LLC
• West Cobb Counseling Center, Inc.

• Non-Pharmacy Dispensing Site in Smyrna, GA
• Providers in Smyrna, 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 13, 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.