| Medical Wellness Center Of Georgia, Llc | |
|
1523 Old Valdosta Rd Ray City GA 31645-7132 | |
| (877) 755-2212 | |
| Not Available |
| Full Name | Medical Wellness Center Of Georgia, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1523 Old Valdosta Rd, Ray City, Georgia |
| Authorized Official Name and Position | Wendy S Pearson (OWNER) |
| Authorized Official Contact | 7064804322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Wellness Center Of Georgia, Llc 1523 Old Valdosta Rd Ray City GA 31645-7132 Ph: (706) 480-4322 | Medical Wellness Center Of Georgia, Llc 1523 Old Valdosta Rd Ray City GA 31645-7132 Ph: (877) 755-2212 |
| NPI Number | 1972003879 |
|---|---|
| Provider Enumeration Date | 02/16/2018 |
| Last Update Date | 07/20/2023 |
| Medicare PECOS PAC ID | 9234480781 |
|---|---|
| Medicare Enrollment ID | O20180921000679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972003879 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Georgia) | Primary |
| Provider Name | Evelyn J Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780645788 PECOS PAC ID: 2062432149 Enrollment ID: I20051205000347 |
| Provider Name | James L Graham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730182106 PECOS PAC ID: 1951435726 Enrollment ID: I20100816000413 |
| Provider Name | Matthew Randall Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326403932 PECOS PAC ID: 7113229253 Enrollment ID: I20160107000359 |
| Provider Name | Angela Marie Burkett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043666860 PECOS PAC ID: 5395038079 Enrollment ID: I20160719001865 |
| Provider Name | Amanda Deen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437643517 PECOS PAC ID: 0143571885 Enrollment ID: I20180919003288 |
| Provider Name | Wendy C Pearson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487808754 PECOS PAC ID: 3678824125 Enrollment ID: I20180921000959 |
| Provider Name | Caitlyn Cook Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588153316 PECOS PAC ID: 4183958002 Enrollment ID: I20190627000203 |
| Provider Name | Cosette Odom Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427262377 PECOS PAC ID: 5294835914 Enrollment ID: I20190719002857 |
| Provider Name | Whitney Denann Sirmans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912468521 PECOS PAC ID: 1850627183 Enrollment ID: I20190724003547 |
| Provider Name | Casey Dix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013539899 PECOS PAC ID: 5395167142 Enrollment ID: I20200624000592 |
Integrated Telehealth Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1523 Old Valdosta Rd Ste B, Ray City, GA 31645 Phone: 877-543-7221 Fax: 877-755-2212 |