1. Home
  2. Directory
  3. Georgia
  4. Conyers
  5. Non Pharmacy Dispensing Site
  6. NPI Profile

WELLSTREET OF GEORGIA PC
NPI 1063061315
Non-Pharmacy Dispensing Site in Conyers, GA

Active since September 10, 2019CLIA 11D2153223 · Waiver
1280 DOGWOOD DR SE, CONYERS, GA 30013(404) 994-4662(404) 994-4663 Get Directions Write a Review

NPPES record last updated: September 10, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Wellstreet Of Georgia Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WELLSTREET OF GEORGIA PC (NPI 1063061315), doing business as Piedmont Urgent Care By Wellstreet, is a healthcare organization registered as a non-pharmacy dispensing site in Conyers, Georgia and active in the NPI registry since September 2019. The organization holds a CLIA Waiver certificate valid through August 22, 2026 and lists Keesha D. Pinacle, Cred Mgr, as its authorized official.

NPPES Registry Identity

NPI1063061315
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameWELLSTREET OF GEORGIA PC
Location Address1280 DOGWOOD DR SEConyers, GA 30013-5046
Mailing Address3350 Riverwood Pkwy Se Ste 1850Atlanta, GA 30339-3300 · (770) 809-3036 · Fax (404) 662-2399
Phone(404) 994-4662
Fax(404) 994-4663
Organization SubpartYes
Authorized OfficialKeesha D. PinacleCred Mgr · (770) 809-3036
Enumeration DateSeptember 10, 2019
✔ NPI 1063061315 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
1280 DOGWOOD DR SE, Conyers, GA 30013
Open in Google Maps ↗

Other Names 1

Doing Business AsPiedmont Urgent Care By Wellstreet

Other Identifiers 1

Medicaid003137211AGA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2153223

Wellstreet Of Georgia, PC · Covington, GA
Active · expires Aug 22, 2026
CLIA Number11D2153223
Laboratory TypeUrgentcare
Certificate Effective DateAugust 23, 2024
Certificate Expiration DateAugust 22, 2026
Laboratory DirectorCassandra Donnelly
Laboratory Phone(770) 809-3036
Laboratory LocationWellstreet Of Georgia, PC5239 Highway 278 NE, Covington, GA 30014
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NATHALIE G BAILEY NP-C
Nurse Practitioner (Family)
1280 DOGWOOD DR SE
CONYERS, GA 30013
Rockdale County (404) 994-4662
APPOLINE MATANDA MELI NP
Nurse Practitioner (Family)
1280 DOGWOOD DR SE
CONYERS, GA 30013
Rockdale County (404) 994-4662

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wellstreet Of Georgia PC's NPI number?

The NPI number for Wellstreet Of Georgia PC is 1063061315. It was assigned to this organization in the NPPES registry on September 10, 2019. The provider is doing business as Piedmont Urgent Care by Wellstreet.

Where is Wellstreet Of Georgia PC located?

Wellstreet Of Georgia PC is located at 1280 Dogwood Dr SE, Conyers, GA 30013. The listed phone number is (404) 994-4662.

What is Wellstreet Of Georgia PC's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Wellstreet Of Georgia PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2153223) is associated with this NPI, valid through August 22, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wellstreet Of Georgia PC was last updated on September 10, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.