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BEWELL INTEGRATIVE HEALTH
NPI 1629863006
Nurse Practitioner in Leesburg, GA

Active since April 14, 2025CLIA 11D2330239 · Waiver
1095 US HIGHWAY 82 W, LEESBURG, GA 31763(229) 800-8102(229) 800-8101 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Bewell Integrative Health NPPES

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

BEWELL INTEGRATIVE HEALTH (NPI 1629863006) is a healthcare organization registered as a nurse practitioner in Leesburg, Georgia and active in the NPI registry since April 2025. The organization holds a CLIA Waiver certificate valid through September 11, 2027 and lists Gail Miranda Ricker, Owner, as its authorized official.

NPPES Registry Identity

NPI1629863006
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameBEWELL INTEGRATIVE HEALTH
Location Address1095 US HIGHWAY 82 WLeesburg, GA 31763-5803
Mailing Address1095 Us Highway 82 WLeesburg, GA 31763-5803 · (229) 800-8102 · Fax (229) 800-8101
Phone(229) 800-8102
Fax(229) 800-8101
Organization SubpartNo
Authorized OfficialGail Miranda RickerOwner · (229) 800-8102
Enumeration DateApril 14, 2025
Last NPPES UpdateMay 7, 2025
NPPES CertifiedMay 7, 2025
✔ NPI 1629863006 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1095 US HIGHWAY 82 W, Leesburg, GA 31763
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 11D2330239

Bewell Integrative Health · Leesburg, GA
Active · expires Sep 11, 2027
CLIA Number11D2330239
Laboratory TypePhysician Office
Certificate Effective DateSeptember 12, 2025
Certificate Expiration DateSeptember 11, 2027
Laboratory DirectorGail M. Ricker
Laboratory Phone(229) 800-8102
Laboratory LocationBewell Integrative Health1095 Us Highway 82 W, Leesburg, GA 31763
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

SHANA SULLIVAN PHARMD
Pharmacist
1095 US HIGHWAY 82 W
LEESBURG, GA 31763
Lee County (229) 800-8100
GAIL MIRANDA RICKER APRN
Nurse Practitioner
1095 US HIGHWAY 82 W
LEESBURG, GA 31763
Lee County (229) 800-8100
SULLIVAN DRUG COMPANY
Pharmacy (Community/Retail Pharmacy)
1095 US HIGHWAY 82 W
LEESBURG, GA 31763
Lee County (229) 800-8100

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 Bewell Integrative Health's NPI number?

The NPI number for Bewell Integrative Health is 1629863006. It was assigned to this organization in the NPPES registry on April 14, 2025.

Where is Bewell Integrative Health located?

Bewell Integrative Health is located at 1095 Us Highway 82 W, Leesburg, GA 31763. The listed phone number is (229) 800-8102.

What is Bewell Integrative Health's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does Bewell Integrative Health hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2330239) is associated with this NPI, valid through September 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bewell Integrative Health was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.