WELLSTAR MEDICAL GROUP, LLC (NPI# 1275992240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275992240 |
| Entity Type | Organization |
| Organization Name | WELLSTAR MEDICAL GROUP, LLC |
| Practice Address |
805 Sandy Plains Rd Marietta GA 30066-6340 |
| Mailing Address |
Po Box 742322 Atlanta GA 30374-2322 |
| Practice Telephone | 4706440173 |
| Practice Fax Number | 7705630733 |
| Mailing Telephone | 4706440173 |
| Mailing Fax Number | 7705630733 |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2016-02-18 |
| Authorized Official Name | MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 4706440095 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
GA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356736250 | Wellstar Medical Group, LLC | Pediatrics | 736 Whitlock Ave Nw, Suite 600, Marietta, GA 30064-0001 | 2015-03-30 |
| 1326333907 | Wellstar Medical Group, LLC | Surgery | 4550 Cobb Parkway Nw, Suite 309-b, Acworth, GA 30101-4180 | 2011-06-13 |
| 1255633004 | Wellstar Medical Group, LLC | Family Medicine | 3747 Roswell Rd Ne, Suite 216, Marietta, GA 30062-6234 | 2010-11-30 |
| 1639533896 | Wellstar Medical Group, LLC | Surgery | 8954 Hospital Dr, Douglasville, GA 30134-2272 | 2016-04-13 |
| 1821466509 | Wellstar Medical Group, LLC | Internal Medicine | 1605 Mulkey Rd, Suite 220, Austell, GA 30106-1127 | 2015-09-11 |
| 1346624160 | Wellstar Medical Group, LLC | Internal Medicine | 1605 Mulkey Rd, Suite 220, Austell, GA 30106-1127 | 2015-07-10 |
| 1588059653 | Wellstar Medical Group, LLC | Family Medicine | 12 Medical Dr Ne, Cartersville, GA 30121-8002 | 2015-04-05 |
| 1720471931 | Wellstar Medical Group, LLC | Pediatrics | 677 Church St Ne, Suite 100 P, Marietta, GA 30060-1101 | 2015-03-12 |
| 1811380025 | Wellstar Medical Group, LLC | Psychiatry & Neurology | 780 Canton Rd Ne, Suite 400, Marietta, GA 30060-7298 | 2015-03-12 |
| 1922405729 | Wellstar Medical Group, LLC | Family Medicine | 11685 Alpharetta Hwy, Suite 300, Roswell, GA 30076-4910 | 2014-11-24 |
| Street Address |
805 SANDY PLAINS RD |
| City | MARIETTA |
| State | GA |
| Zip Code | 30066-6340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417935701 | Wellstar Homecare Billing, LLC | Pharmacy | 805 Sandy Plains Rd, Marietta, GA 30066-6340 | 2006-01-06 |
| 1457743304 | Seibattu Kallon | Nurse Practitioner | 805 Sandy Plains Rd, Marietta, GA 30066-6340 | 2015-03-02 |
| 1164796009 | Maria De Freitas | Physician Assistant | 805 Sandy Plains Rd, Wellstar Medical Group, Marietta, GA 30066-6340 | 2012-02-23 |
| 1518139195 | Wellstar Professional Services, LLC | Internal Medicine | 805 Sandy Plains Rd, Wpg-cbo, Marietta, GA 30066-6340 | 2008-03-24 |
| 1043405905 | Sherlyne Sidney | Physical Therapist | 805 Sandy Plains Rd, Marietta, GA 30066-6340 | 2007-09-12 |
| 1447442314 | Donald H Campbell | Surgery | 805 Sandy Plains Rd, Marietta, GA 30066-6340 | 2007-08-15 |
| 1437219656 | Wellstar Health System, Inc. | Point of Service | 805 Sandy Plains Rd, Marietta, GA 30066-6340 | 2006-12-11 |
| 1750489720 | Richard Hart | Internal Medicine | 805 Sandy Plains Rd, Marietta, GA 30066-6340 | 2006-09-21 |
| 1215035548 | Marcia Lee Delk | Internal Medicine | 805 Sandy Plains Rd, Marietta, GA 30066-6340 | 2006-09-20 |
| 1073591376 | Wellstar Home Health, LLC | Home Health | 805 Sandy Plains Rd, Marietta, GA 30066-6340 | 2006-01-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598253684 | Comfort Community Center, LLC | Skilled Nursing Facility | 2440 Sandy Plains Road, Blvd 21, Suite 100, Marietta, GA 30066 | 2018-04-25 |
| 1538681994 | Passionate Care | In Home Supportive Care | 1110 Renfro Ln., Marietta, GA 30066 | 2017-07-07 |
| 1437510443 | Steven Caras | Internal Medicine | 2682 Bonaire Terrace, Marietta, GA 30066 | 2016-03-18 |
| 1275918781 | Latifat Bolajoko Asemota | Nurse Practitioner | 410 Nottingham Dr, Marietta, GA 30066 | 2015-07-26 |
| 1497094205 | Changing Phases Behavioral Support, Inc | Internal Medicine | 3655 Canton Rd Ste 201, Marietta, GA 30066 | 2013-02-14 |
| 1659618916 | Alison Nicole Sims | Occupational Therapist | 2465 Canopy Drive, Marietta, GA 30066 | 2013-01-07 |
| 1790044907 | Antoine Jose Davenport | Massage Therapist | 4686 Jamerson Creek Dr, Marietta, GA 30066 | 2012-05-08 |
| 1174898548 | Angel Elizabeth Nofziger | Nurse Practitioner | 3750 Palladian Village Dr Ste 300, Marietta, GA 30066 | 2012-03-18 |
| 1912298019 | Nancy Jean Slack | Pharmacist | 2833 Canton Road, Marietta, GA 30066 | 2011-04-22 |
| 1336456078 | Mario B Miller Sr. | Chiropractor | 50 Barrett Parkway, Suite 3005#126, Marietta, GA 30066 | 2010-09-01 |
| Find all providers in zip 30066 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518129774 | Independent Physical Therapy of Georgia, LLC | Clinic/Center | 400 Tower Rd Ne Ste 140, Marietta, GA 30060-9412 | 2008-06-30 |
| 1801926381 | Sumner Neurology Associates, Pllc | Clinic/Center | 1000 Johnson Ferry Rd Bldg F, Ste.120, Marietta, GA 30068-2114 | 2007-03-06 |
| 1588724462 | Optimum Healthcare Associates,llc | Clinic/Center | 2551 Roswell Rd Ste 100, Marietta, GA 30062-4761 | 2006-12-11 |
| 1134501422 | Wellstar Health System, LLC | Clinic/Center | 793 Sawyer Rd, Marietta, GA 30062-2222 | 2015-06-23 |
| 1013292119 | Independent Physical Therapy of Georgia, LLC | Clinic/Center | 1205 Johnson Ferry Rd Ste 130, Marietta, GA 30068-5418 | 2011-10-20 |
| 1811203920 | Benchmark Healthcare Services LLC | Clinic/Center | 400 Tower Rd Ne Ste 140, Marietta, GA 30060-9412 | 2010-08-26 |
| 1720394836 | Benchmark Healthcare Services LLC | Clinic/Center | 2580 Windy Hill Rd Se Ste 300, Marietta, GA 30067-8642 | 2010-08-26 |
| 1588978530 | Integrated Health Solutions of Marietta, LLC | Clinic/Center | 3405 Dallas Hwy Sw, Suite 301, Marietta, GA 30064-6426 | 2010-08-02 |
| 1326275918 | Independent Physical Therapy of Georgia, LLC | Clinic/Center | 2580 Windy Hill Rd Se Ste 300, Marietta, GA 30067-8642 | 2009-06-22 |
| 1417996844 | Prohbo - Marietta LLC | Clinic/Center | 1455 Bells Ferry Rd, Suite 100, Marietta, GA 30066-6078 | 2006-06-04 |
| Find all providers in MARIETTA | ||||
Please comment or provide details below to improve the information on WELLSTAR MEDICAL GROUP, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.