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WELLNESS PRIMARY CARE LLC NPI 1124291927


NPI Information

NPI: 1124291927
Provider Name: WELLNESS PRIMARY CARE, LLC
Classification: Case Manager/Care Coordinator - 171M00000X
Entity Type: Organization

CLIA Number: 11D1062906

Address:
5456 JIMMY CARTER BLVD
SUITE 240
NORCROSS, GA
ZIP 30093
Phone: (678) 380-9889
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WELLNESS PRIMARY CARE, LLC is a case manager care coordinator in Norcross, GA. The provider is a person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. WELLNESS PRIMARY CARE, LLC NPI is 1124291927. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5456 JIMMY CARTER BLVD
SUITE 240
NORCROSS, GA
ZIP 30093-511
Phone: (678) 380-9889

The provider's authorized official is Paul Huy-dao Nguyen .
The authorized official title is Physician and has the following contact phone number (678) 380-9889.

The CLIA number assigned to this NPI record is 11D1062906 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/12/2008 and was last updated on 8/24/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1171M00000XCase Manager/Care Coordinator047813GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000884793CMEDICAIDGEORGIA
211BDXHBMEDICARE PINGEORGIA
3H19592OTHERGEORGIAUPIN
4GRP6225OTHERGEORGIAMEDICARE GROUP NO.

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.