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GRUV WELLNESS CLINIC
NPI 1700743069
Nurse Practitioner - Primary Care in Conyers, GA

Active since January 08, 2026CLIA 11D2339815 · Waiver
1240 SIGMAN RD NW STE 103, CONYERS, GA 30012(404) 857-4788(404) 596-6295 Get Directions Write a Review

NPPES record last updated: May 27, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 27, 2026, Mar 9, 2026, Jan 8, 2026 (3 updates tracked since 2026).

About Gruv Wellness Clinic NPPES

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

GRUV WELLNESS CLINIC (NPI 1700743069) is a healthcare organization registered as a primary care in Conyers, Georgia and active in the NPI registry since January 2026. The organization holds a CLIA Waiver certificate valid through March 8, 2028 and lists Samantha Banks, Owner, as its authorized official.

NPPES Registry Identity

NPI1700743069
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameGRUV WELLNESS CLINIC
Location Address1240 SIGMAN RD NW STE 103Conyers, GA 30012-3934
Mailing Address1240 Sigman Rd Nw Ste 103Conyers, GA 30012-3934 · (404) 857-4788 · Fax (404) 596-6295
Phone(404) 857-4788
Fax(404) 596-6295
Organization SubpartNo
Authorized OfficialSamantha BanksOwner · (404) 857-4788
Enumeration DateJanuary 8, 2026
Last NPPES UpdateMay 27, 20263 updates tracked since enumeration
NPPES CertifiedMay 27, 2026
✔ NPI 1700743069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
1240 SIGMAN RD NW STE 103, Conyers, GA 30012
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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

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 11D2339815

Gruv Wellness Clinic · Conyers, GA
Active · expires Mar 8, 2028
CLIA Number11D2339815
Laboratory TypePractitioner Other
Certificate Effective DateMarch 9, 2026
Certificate Expiration DateMarch 8, 2028
Laboratory DirectorSamantha L. Banks
Laboratory Phone(404) 857-4788
Laboratory LocationGruv Wellness Clinic1240 Sigman Road, NW, Suite 103, Conyers, GA 30012
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

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

SAMANTHA BANKS MSN, FNP-C
Nurse Practitioner
1240 SIGMAN RD NW STE 103
CONYERS, GA 30012
Rockdale County (404) 857-4788

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 Gruv Wellness Clinic's NPI number?

The NPI number for Gruv Wellness Clinic is 1700743069. It was assigned to this organization in the NPPES registry on January 8, 2026.

Where is Gruv Wellness Clinic located?

Gruv Wellness Clinic is located at 1240 Sigman Rd NW Ste 103, Conyers, GA 30012. The listed phone number is (404) 857-4788.

What is Gruv Wellness Clinic's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Does Gruv Wellness Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2339815) is associated with this NPI, valid through March 8, 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 Gruv Wellness Clinic was last updated on May 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.