IVYDALE WELLNESS CENTER LLC
NPI 1659919066
Nurse Practitioner - Psychiatric/Mental Health in Winder, GA
About Ivydale Wellness Center Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IVYDALE WELLNESS CENTER LLC (NPI 1659919066), doing business as Ivydale Wellness Center, is a healthcare organization registered as a psychiatric/mental health in Winder, Georgia and active in the NPI registry since December 2019. The organization lists Ablavi Adodo Agomessou, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ivydale Wellness Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Ivydale Wellness Center LLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Ivydale Wellness Center LLC's NPI number?
The NPI number for Ivydale Wellness Center LLC is 1659919066. It was assigned to this organization in the NPPES registry on December 16, 2019. The provider is doing business as Ivydale Wellness Center.
Where is Ivydale Wellness Center LLC located?
Ivydale Wellness Center LLC is located at 361 Resource Pkwy, Winder, GA 30680. The listed phone number is (770) 291-0419.
What is Ivydale Wellness Center LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Ivydale Wellness Center LLC enrolled in Medicare?
Yes. Ivydale Wellness Center LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Ivydale Wellness Center LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Ivydale Wellness Center LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Ivydale Wellness Center LLC accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 2 other insurers list Ivydale Wellness Center LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Ivydale Wellness Center LLC was last updated on January 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Ivydale Wellness Center Llc · NPI 1659919066
Psychiatric/Mental Health organization in Winder, Georgia. Organization record, active in the CMS NPPES registry since December 16, 2019.
## Identity
- **NPI:** 1659919066 (Entity type: Organization)
- **Enumerated:** December 16, 2019
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Also known as:** Ivydale Wellness Center (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Ablavi Agomessou, OWNER
## Practice location
- **Address:** 361 RESOURCE PKWY, Winder, GA 30680-8364
- **Phone:** (770) 291-0419
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 15, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1659919066) · Data from the CMS NPPES public registry.