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Wellstreet of Georgia PC

Non-Pharmacy Dispensing Site in Conyers, GA · enumerated 2019 · authorized official Keesha Pinacle, Cred Mgr.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1063061315

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Registry record

Entity type Organization (Type 2)
Legal business name Wellstreet of Georgia PC
Parent organization Wellstreet of Georgia PC
Practice address 1280 Dogwood Dr Se, Conyers, GA, 30013
Phone (404) 994-4662
Fax (404) 994-4663
Enumeration date Sep 10, 2019
Last updated in NPPES Sep 10, 2019

Taxonomy & classification

332900000X Non-Pharmacy Dispensing Site Suppliers Primary

Authorized official

Name Keesha Pinacle
Title Cred Mgr
Phone (770) 809-3036

Other identifiers

Identifier Type State Issuer
003137211A Medicaid GA -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Wellstreet of Georgia PC?
NPPES lists Keesha Pinacle (Cred Mgr) as the authorized official for this organization.
What is the NPI number for Wellstreet of Georgia PC?
The NPI for Wellstreet of Georgia PC is 1063061315, a Type 2 (organization) record in the CMS NPPES registry.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2019-09-10.