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EVERGREEN PRIMARY CARE AND WELLNESS PC NPI 1285134999


NPI Information

NPI: 1285134999
Provider Name: EVERGREEN PRIMARY CARE AND WELLNESS PC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 11D2145565

Address:
2450 ATLANTA HWY STE 803
CUMMING, GA
ZIP 30040
Phone: (470) 253-7944
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EVERGREEN PRIMARY CARE AND WELLNESS PC is an internal medicine in Cumming, GA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. EVERGREEN PRIMARY CARE AND WELLNESS PC NPI is 1285134999. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2450 ATLANTA HWY STE 803
CUMMING, GA
ZIP 30040-252
Phone: (470) 253-7944
Fax: (678) 807-6144

The provider's authorized official is Heather B Wanner .
The authorized official title is Owner and has the following contact phone number (470) 253-7944.

The CLIA number assigned to this NPI record is 11D2145565 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/19/2018 and was last updated on 3/8/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QG0300XFamily MedicineGeriatric MedicineRN229572GEORGIANo
2207R00000XInternal Medicine52651GEORGIAYes
3363LF0000XNurse PractitionerFamilyRN229572GEORGIANo

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: 4/28/2024

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.