WELLSTREET OF GEORGIA PC
NPI 1912588310
Non-Pharmacy Dispensing Site in Fayetteville, GA
NPI Status: Active since April 16, 2021
Contact Information
749 LANIER AVE W
FAYETTEVILLE, GA
ZIP 30214
Phone: (770) 835-4925
- Organization
- Non-Pharmacy Dispensing Site
- CLIA Number: 11D2315924
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-19-2026
About WELLSTREET OF GEORGIA PC
This page provides the complete NPI Profile along with additional information for Wellstreet Of Georgia Pc, a provider established in Fayetteville, Georgia operating as a Non-pharmacy Dispensing Site. The healthcare provider is registered in the NPI registry with number 1912588310 assigned on April 2021. The practitioner's primary taxonomy code is 332900000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Katie Cassarino (Practice Manager)
- NPI
- 1912588310
- Provider Name
- WELLSTREET OF GEORGIA PC
- Entity Type
- Organization
- Location Address
- 749 LANIER AVE W FAYETTEVILLE, GA 30214
- Location Phone
- (770) 835-4925
- Mailing Address
- 3350 RIVERWOOD PKWY SE STE 1850 ATLANTA, GA 30339
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 04-16-2021
- Last Update Date
- 04-16-2021
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Non-Pharmacy Dispensing Site
- Taxonomy Code
- 332900000X
- Type
- Suppliers
- Taxonomy Description
- A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2315924
- Facility Type
- Physician Office
- Certificate Effective Date
- December 20, 2024
- Certificate Expiration Date
- December 19, 2026
- Laboratory Director
- CLARK D. GREGORY
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Wellstreet Of Georgia Pc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1912588310, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 60 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1912588310, enumerated as an "organization" on April 16, 2021.
The provider is located at 749 LANIER AVE W FAYETTEVILLE, GA 30214 and the phone number is (770) 835-4925.
Non-Pharmacy Dispensing Site with taxonomy code 332900000X.
