Healthcare Provider Details

I. General information

NPI: 1447134168
Provider Name (Legal Business Name): THRIVE WOUND RECOVERY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 NELSON ST SW STE 16121
ATLANTA GA
30313-1354
US

IV. Provider business mailing address

5539 TIMBERWIND CIR
LAKE PARK GA
31636-2888
US

V. Phone/Fax

Practice location:
  • Phone: 229-630-2001
  • Fax: 229-231-3089
Mailing address:
  • Phone: 229-630-2001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. ZAKIYYAH VASHE WEATHERSPOON
Title or Position: CEO
Credential: FNP-BC, PMHNP-BC
Phone: 229-630-2001