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EVERGREEN PRIMARY CARE AND WELLNESS PC
NPI 1285134999
Internal Medicine in Cumming, GA

Active since February 19, 2018CLIA 11D2145565 · Waiver
2450 ATLANTA HWY STE 803, CUMMING, GA 30040(470) 253-7944(678) 807-6144 Get Directions Write a Review

NPPES record last updated: March 8, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 8, 2018, Feb 19, 2018 (2 updates tracked since 2018).

About Evergreen Primary Care And Wellness Pc NPPES

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

EVERGREEN PRIMARY CARE AND WELLNESS PC (NPI 1285134999) is a healthcare organization registered as an internal medicine in Cumming, Georgia and active in the NPI registry since February 2018. The organization holds a CLIA Waiver certificate valid through March 11, 2028 and lists Heather B Wanner, Owner, as its authorized official.

NPPES Registry Identity

NPI1285134999
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameEVERGREEN PRIMARY CARE AND WELLNESS PC
Location Address2450 ATLANTA HWY STE 803Cumming, GA 30040-1252
Mailing Address5485 Bethelview Rd Ste 360-331Cumming, GA 30040-9735 · (470) 253-7944 · Fax (678) 807-6144
Phone(470) 253-7944
Fax(678) 807-6144
Organization SubpartNo
Authorized OfficialHeather B WannerOwner · (470) 253-7944
Enumeration DateFebruary 19, 2018
Last NPPES UpdateMarch 8, 20182 updates tracked since enumeration
✔ NPI 1285134999 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 52651
Definition
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.
Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X · License RN229572 (GA)
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License RN229572 (GA)
2450 ATLANTA HWY STE 803, Cumming, GA 30040
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Evergreen Primary Care And Wellness Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Evergreen Primary Care And Wellness PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Heather Wanner, FNP-BC
Nurse Practitioner
NPI 1720235567
2450 ATLANTA HWY STE 803
Cumming, GA 30040
(470) 253-7944
✔ PECOS✔ Accepts MedicareSame address
Malcolm Traxler, MD
Internal Medicine
NPI 1124013172
2540 ATLANTA HWY STE 803
Cumming, GA 30040
(470) 253-7944
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 11D2145565

Evergreen Primary Care And Wellness, PC · Cumming, GA
Active · expires Mar 11, 2028
CLIA Number11D2145565
Laboratory TypePhysician Office
Certificate Effective DateMarch 12, 2026
Certificate Expiration DateMarch 11, 2028
Laboratory DirectorHeather B. Wanner
Laboratory Phone(470) 253-7944
Laboratory LocationEvergreen Primary Care And Wellness, PC2450 Atlanta Hwy, Suite 803, Cumming, GA 30040
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Evergreen Primary Care And Wellness PC's NPI number?

The NPI number for Evergreen Primary Care And Wellness PC is 1285134999. It was assigned to this organization in the NPPES registry on February 19, 2018.

Where is Evergreen Primary Care And Wellness PC located?

Evergreen Primary Care And Wellness PC is located at 2450 Atlanta Hwy Ste 803, Cumming, GA 30040. The listed phone number is (470) 253-7944.

What is Evergreen Primary Care And Wellness PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Evergreen Primary Care And Wellness PC enrolled in Medicare?

Yes. Evergreen Primary Care And Wellness PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Evergreen Primary Care And Wellness PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Evergreen Primary Care And Wellness PC, in Internal Medicine and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Evergreen Primary Care And Wellness PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2145565) is associated with this NPI, valid through March 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Evergreen Primary Care And Wellness PC was last updated on March 8, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.