MEDICARE: THRYVWELL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1316870512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRYVWELL HEALTH

Provider Business Mailing Address
First Line	:	8735 DUNWOODY PL STE 12983
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30350-2995
Country	:	US
Telephone Number	:	678-630-1356
Fax Number	:

Provider Business Practice Location Address
First Line	:	8735 DUNWOODY PL STE 12983
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30350-2995
Country	:	US
Telephone Number	:	678-630-1356
Fax Number	:

Authorized Official
Title or Position	:	CHIEF MEDICAL OFFICER
Name	:	DR. GLENDA PETTAWAY
Credential	:	MD
Telephone Number	:	678-630-1356

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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