Wellstreet of Georgia PC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

WELLSTREET OF GEORGIA PC

Practice address

1755 Highway 34 E
Suite 2150
Newnan, GA 30265-5631

Phone

(770) 202-2121

NPI assigned

Feb 15, 2007

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 Manager

Phone

(770) 809-3036

Specialties & licenses 1

Addresses

Tax ID family

Summit Urgent Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Summit Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Fayetteville, GA
  • NPI 1326405903
  NPD tax ID

Locations

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575244800000",
    "number": "1942343405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 HIGHWAY 34 E",
            "address_2": "SUITE 2150",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302655631",
            "telephone_number": "770-202-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 HIGHWAY 34 E",
            "address_2": "SUITE 2150",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302655631",
            "telephone_number": "770-202-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTREET OF GEORGIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2019-12-02",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "TONIA",
        "authorized_official_middle_name": "RANA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "770-809-3036"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wellspring Medical Group, LLC
• Wellstreet of Georgia PC (Piedmont Urgent Care by Wellstreet)
• Wellstreet of Georgia PC (Piedmont Urgent Care)
• Wellstreet of Georgia PC (Piedmont Urgent Care by Wellstreet)
• Wellstreet of Georgia PC
• Wellstreet of Georgia PC
• Lisa Hartsfield Werginz, CCC / SLP
• Lynette Jeanell Wesley, PT
• Nancy Wesselink, LMSW CEAP
• Carly West

• Emergency Medicine Physician in Newnan, GA
• Providers in Newnan, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.