NPIMap

Organization Active NPI

Wellstreet of Georgia PC

  • Non-Pharmacy Dispensing Site
  • Austell, GA
National Provider Identifier
1982195343
Registry record updated May 22, 2018
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
3999 Austell Rd Ste 901
Austell, GA 30106-1160
Phone
(770) 809-3032
NPI assigned
May 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Authorized official

Name
Samantha Alvord
Title
Practice Manager
Phone
(770) 521-6690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X GA Primary

Addresses

Primary practice location

3999 Austell Rd Ste 901
Austell, GA 30106-1160

Mailing address

3350 Riverwood Pkwy SE Ste 1850
Atlanta, GA 30339-3300
Phone (770) 809-3036

Other identifiers 1

IdentifierTypeStateIssuer
003135883CMedicaidGA

Other names 1

  • Piedmont Urgentcare by Wellstreet Doing business as

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
11D2036896Piedmont Urgentcare by Wellstreet3999 Austell Road, #901, Austell, GA 30106Certificate of waiverFeb 14, 2028

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 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526947200000",
    "number": "1982195343",
    "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": "3999 AUSTELL RD STE 901",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061160",
            "telephone_number": "770-809-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTREET OF GEORGIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-05-22",
        "status": "A",
        "authorized_official_last_name": "ALVORD",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "770-521-6690"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003135883C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piedmont Urgentcare by Wellstreet",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.