PORT-A-WELLNESS LLC – Primary Care Clinic/Center, NPI 1063787901

PORT-A-WELLNESS LLC is a healthcare provider. based in East point, Georgia. specializing in Primary Care Clinic/Center. The organization holds a License No. 042668 (GA). The NPI Number for PORT-A-WELLNESS LLC is 1063787901

Main info

Organization
Name
PORT-A-WELLNESS LLC
NPI
1063787901
Phone
(678) 705-1691
Address
1670 WASHINGTON AVE
Authorized Official
DR. RAMONA ANN MINNIS MEDICAL DIRECTOR M..D.
Enumeration Date
11 March 2012
Last Update Date
11 March 2012
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

Provider Addresses for PORT-A-WELLNESS LLC

  • 1670 WASHINGTON AVE

    EAST POINT, GA 303444248

    Phone: (678) 705-1691

    Fax: (855) 289-7475

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30344)

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Reviews

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Frequently asked questions

How do payers reference PORT-A-WELLNESS LLC?
For PORT-A-WELLNESS LLC, use NPI 1063787901 as the unique 10-digit identifier.
Active or inactive — what applies to PORT-A-WELLNESS LLC?
You should see PORT-A-WELLNESS LLC as active in CMS-hosted NPPES data.
What area of care is associated with PORT-A-WELLNESS LLC?
PORT-A-WELLNESS LLC's record emphasizes Primary Care Clinic/Center. Clinical services aligned with this taxonomy classification.
Is PORT-A-WELLNESS LLC located near East Point?
PORT-A-WELLNESS LLC currently maps to East Point, Georgia in this extract.
When was this NPI issued?
Enumeration for PORT-A-WELLNESS LLC is noted as March 11, 2012 where the registry provides it.

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