WELLSPRING FAMILY MEDICAL CENTER, INC (NPI# 1538434311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538434311 |
| Entity Type | Organization |
| Organization Name | WELLSPRING FAMILY MEDICAL CENTER, INC |
| Practice Address |
2759 Mount Zion Pkwy Suite 3 Jonesboro GA 30236-2568 |
| Mailing Address |
2759 Mount Zion Pkwy Ste C Jonesboro GA 30236-2568 |
| Practice Telephone | 6782898338 |
| Practice Fax Number | 7706030515 |
| Mailing Telephone | 6782898338 |
| Mailing Fax Number | 7706030515 |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2020-03-12 |
| Authorized Official Name | MRS. OLUBUNMI A AYENI (OFFICE MANAGER) |
| Authorized Official Telephone | 6782898338 |
| Authorized Official Credential | REGISTERED NURSE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
43534 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00794857D | 05 | |
| GA | 00794857C | 05 |
| Street Address |
2759 MOUNT ZION PKWY SUITE 3 |
| City | JONESBORO |
| State | GA |
| Zip Code | 30236-2568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275572190 | Oluropo A Ayeni | Internal Medicine | 2759 Mount Zion Pkwy, Suite C, Jonesboro, GA 30236-2568 | 2006-06-06 |
| 1508482746 | Olubunmi Tina Ayeni | Nurse Practitioner | 2759 Mount Zion Pkwy, Jonesboro, GA 30236-2568 | 2020-06-23 |
| 1356971568 | Cassandra Amey | Speech-Language Pathologist | 2759 Mount Zion Pkwy, Jonesboro, GA 30236-2568 | 2020-01-16 |
| 1861056871 | Jasmine Merrell | Occupational Therapist | 2759 Mount Zion Pkwy, Jonesboro, GA 30236-2568 | 2019-04-24 |
| 1447784210 | Alexandra Shular | Speech-Language Pathologist | 2759 Mount Zion Pkwy, Suite A, Jonesboro, GA 30236-2568 | 2017-04-18 |
| 1376928903 | Mt Zion Urgent Care Center LLC | Clinic/Center | 2759 Mount Zion Pkwy, Suite D, Jonesboro, GA 30236-2568 | 2015-07-24 |
| 1063794154 | Bisol Home Care Services, Inc | In Home Supportive Care | 2759 Mount Zion Pkwy, Suite D, Jonesboro, GA 30236-2568 | 2011-09-14 |
| 1043448392 | Covenant Medical Diagnostics | Clinical Medical Laboratory | 2759 Mount Zion Pkwy, Suite A/b, Jonesboro, GA 30236-2568 | 2009-06-25 |
| 1710129465 | Michael O Oyerinde | Clinical Medical Laboratory | 2759 Mount Zion Pkwy, Suite A/b, Jonesboro, GA 30236-2568 | 2009-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1639609555 | New Beginnings Behavioral Counseling,llc | Social Worker | 9456 S Main St Ste E2, Jonesboro, GA 30236 | 2017-06-13 |
| 1437696762 | Clarissa Alexandra Poole | Counselor | 2106 Fair Ridge Ct, Jonesboro, GA 30236 | 2017-01-25 |
| 1588012892 | Sundance Healthcare Service Inc | In Home Supportive Care | 7861 Collinswood Court, Jonesboro, GA 30236 | 2016-05-26 |
| 1942669205 | Adrianne Smiley Gurley | Occupational Therapist | 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 | 2016-02-15 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1467827402 | Surrell Porter | Nurse Practitioner | 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | 2015-12-02 |
| 1740688910 | Jacqueline Carolyn Edwards | Registered Nurse | 8081 Tara Blvd, 265, Jonesboro, GA 30236 | 2014-12-19 |
| 1770991861 | Lower Extremity Diagnostics, LLC | Podiatrist | 6911 Tara Boulevard, Jonesboro, GA 30236 | 2014-08-01 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| Find all providers in zip 30236 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| 1578113585 | Centro Prenatal De Gwinnett LLC | Clinic/Center | 575 W Pike St Ste 1, Lawrenceville, GA 30046-7685 | 2019-09-12 |
| 1316508815 | Atlanta Health Clinic LLC | Clinic/Center | 2480 Windy Hill Rd Se Ste 404, Marietta, GA 30067-8658 | 2019-06-25 |
| 1659880847 | Jones Medical and Educational Consultants | Clinic/Center | 8954 Hospital Dr Bldg C, Douglasville, GA 30134-2200 | 2017-09-20 |
| 1477005593 | Hirenirali LLC | Clinic/Center | 12390 Beragio Pl, Alpharetta, GA 30004-4188 | 2016-10-25 |
| 1851840961 | Tele Doctor Direct Inc | Clinic/Center | 1250 Powers Ferry Cmn Se, Suite 100, Marietta, GA 30067-6046 | 2016-09-30 |
| 1154870533 | Life Point Medical, LLC | Clinic/Center | 189 Bo James Street, Suite 105, Clayton, GA 30525 | 2016-09-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.