Ivydale Wellness Center LLC
NPI 1659919066 · Psychiatric/Mental Health Nurse Practitioner · Winder, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ivydale Wellness Center LLC is a Psychiatric/Mental Health Nurse Practitioner organization in Winder, GA (NPI 1659919066).
Provider details
- NPI number
- 1659919066
- Entity type
- Organization
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Ablavi Agomessou, Owner(404) 819-8701
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 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
- Ivydale Wellness Center
- Doing business as
- Ivydale Wellness Center
Registry dates
- Enumerated
- 2019-12-16
- Last updated
- 2026-01-15
- Certified
- 2026-01-15
Frequently asked questions
- What is Ivydale Wellness Center LLC's NPI number?
- Ivydale Wellness Center LLC's National Provider Identifier (NPI) is 1659919066, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ivydale Wellness Center LLC?
- Ivydale Wellness Center LLC is classified in the NPPES registry as Psychiatric/Mental Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Ivydale Wellness Center LLC located?
- Ivydale Wellness Center LLC's practice location on file with NPPES is 361 Resource Pkwy, Winder, GA 30680-8364.
- What is Ivydale Wellness Center LLC's phone number?
- The practice phone number listed in the NPPES registry for Ivydale Wellness Center LLC is (770) 291-0419.
- Does Ivydale Wellness Center LLC accept Medicare?
- Ivydale Wellness Center LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Ivydale Wellness Center LLC?
- The authorized official listed on Ivydale Wellness Center LLC's NPPES record is Ablavi Agomessou, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ivydale Wellness Center LLC's NPI active?
- Yes — Ivydale Wellness Center LLC's NPI (1659919066) is active in the NPPES registry as of the last update on 2026-01-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.