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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

HEATHER IVY SOCIETY
NPI 1902713662
Pharmacy in Atlanta, GA

Active since August 26, 2026CLIA 11D2317438 · Waiver
2193 CASCADE RD SW, ATLANTA, GA 30311(844) 884-9691(404) 907-4052 Get Directions Write a Review

NPPES record added: August 26, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Heather Ivy Society NPPES

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

HEATHER IVY SOCIETY (NPI 1902713662) is a healthcare organization registered as a pharmacy in Atlanta, Georgia and active in the NPI registry since August 2026. The organization holds a CLIA Waiver certificate valid through January 23, 2027 and lists Zandraetta Tims Cook, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1902713662
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameHEATHER IVY SOCIETY
Location Address2193 CASCADE RD SWAtlanta, GA 30311-2862
Mailing Address2193 Cascade Rd SwAtlanta, GA 30311-2862 · (844) 884-9691 · Fax (404) 907-4052
Phone(844) 884-9691
Fax(404) 907-4052
Organization SubpartYes
Authorized OfficialZandraetta Tims CookExecutive Director · (615) 305-9006
Enumeration DateAugust 26, 2026
NPPES CertifiedAugust 26, 2026
✔ NPI 1902713662 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
2193 CASCADE RD SW, Atlanta, GA 30311
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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 11D2317438

Heather Ivy Society · Forest Park, GA
Active · expires Jan 23, 2027
CLIA Number11D2317438
Laboratory TypeCommunity Clinic
Certificate Effective DateJanuary 24, 2025
Certificate Expiration DateJanuary 23, 2027
Laboratory DirectorZandraetta Tims Cook
Laboratory Phone(844) 884-9691
Laboratory LocationHeather Ivy Society381 Forest Parkway, Suite B, Forest Park, GA 30297
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.

INFUSIMED, LLC
Internal Medicine (Infectious Disease)
2193 CASCADE RD SW
ATLANTA, GA 30311
Fulton County (844) 884-9691
DR. ZANDRAETTA L TIMS-COOK MD, MPH
Internal Medicine (Infectious Disease)
2193 CASCADE RD SW
ATLANTA, GA 30311
Fulton County (844) 884-9691

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 Heather Ivy Society's NPI number?

The NPI number for Heather Ivy Society is 1902713662. It was assigned to this organization in the NPPES registry on August 26, 2026.

Where is Heather Ivy Society located?

Heather Ivy Society is located at 2193 Cascade Rd SW, Atlanta, GA 30311. The listed phone number is (844) 884-9691.

What is Heather Ivy Society's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Heather Ivy Society hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2317438) is associated with this NPI, valid through January 23, 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 Heather Ivy Society was last updated on August 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 43 days 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.