Sacred Waters, LLC
NPI 1033546049 · Other Technician · Fayetteville, GA
Sacred Waters, LLC is a Other Technician organization in Fayetteville, GA (NPI 1033546049).
Provider details
- NPI number
- 1033546049
- Entity type
- Organization
- Primary specialty
- Other TechnicianTechnologists, Technicians & Other Technical Service Providers
- Organization subpart
- No
- Authorized official
- Kelly Jefferson, Managing Directo(770) 460-9122
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Sacred Waters Wellness
Registry dates
- Enumerated
- 2013-10-04
- Last updated
- 2013-10-04
Frequently asked questions
- What is Sacred Waters, LLC's NPI number?
- Sacred Waters, LLC's National Provider Identifier (NPI) is 1033546049, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Sacred Waters, LLC?
- Sacred Waters, LLC is classified in the NPPES registry as Other Technician (Technologists, Technicians & Other Technical Service Providers).
- Where is Sacred Waters, LLC located?
- Sacred Waters, LLC's practice location on file with NPPES is 500 Lanier Ave W Ste 701, Fayetteville, GA 30214-7643.
- What is Sacred Waters, LLC's phone number?
- The practice phone number listed in the NPPES registry for Sacred Waters, LLC is (770) 460-9122.
- Who is the authorized official for Sacred Waters, LLC?
- The authorized official listed on Sacred Waters, LLC's NPPES record is Kelly Jefferson, Managing Directo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Sacred Waters, LLC's NPI active?
- Yes — Sacred Waters, LLC's NPI (1033546049) is active in the NPPES registry as of the last update on 2013-10-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.