NPIMap

Organization Active NPI

Wellness Alternative Medicine,LLC

  • Primary Care Clinic/Center
  • Atlanta, GA
National Provider Identifier
1962957605
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
WELLNESS ALTERNATIVE MEDICINE,LLC
Practice address
619 Boulevard NE
Suite a
Atlanta, GA 30308-2701
Phone
(770) 256-7033
Fax
(678) 705-3717
NPI assigned
Aug 23, 2016
Last updated
Aug 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Authorized official

Name
Dr. Rasean Hodge, M.D.NPI 1972543726
Title
Owner/Partner
Phone
(770) 256-7033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 054221 GA
Infusion Therapy Clinic/Center 261QI0500X 054221 GA
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

619 Boulevard NE
Suite a
Atlanta, GA 30308-2701

Mailing address

619 Boulevard Drive
Suite a
Atlanta, GA 30308
Phone (770) 256-7033

National Provider Directory

National Provider Directory

Locations

619 Boulevard NE
Ste A
Atlanta, GA 30308
Phone (770) 256-7033

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471910400000",
    "number": "1962957605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 BOULEVARD DRIVE",
            "address_2": "SUITE A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30308",
            "telephone_number": "770-256-7033",
            "fax_number": "678-705-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 BOULEVARD NE",
            "address_2": "SUITE A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082701",
            "telephone_number": "770-256-7033",
            "fax_number": "678-705-3717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS ALTERNATIVE MEDICINE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-23",
        "last_updated": "2016-08-23",
        "status": "A",
        "authorized_official_last_name": "HODGE",
        "authorized_official_first_name": "RASEAN",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "770-256-7033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "054221",
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "GA",
            "license": "054221",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.