WELLSTAR COMMUNITY HOSPICE, LLC (NPI# 1407811060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407811060 |
| Entity Type | Organization |
| Organization Name | WELLSTAR COMMUNITY HOSPICE, LLC |
| Other Organization Name | WELLSTAR COMMUNITY HOSPICE |
| Practice Address |
4040 Hospital West Dr Austell GA 30106-8117 |
| Practice Telephone | 7707326710 |
| Practice Fax Number | 7707326732 |
| Mailing Telephone | 7707326710 |
| Mailing Fax Number | 7707326732 |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2011-01-31 |
| Authorized Official Name | ANTHONY J BUDZINSKI (ACTING PRESIDENT & CEO) |
| Authorized Official Telephone | 7707927600 |
| Is Organization Subpart | Y |
| Parent Organization Name | WELLSTAR HEALTH SYSTEM, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | 033077H | GA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000373799A | 05 |
| Other Name | Type Code |
|---|---|
| WellStar Community Hospice | Doing Business As Name - Organization |
| Street Address |
4040 HOSPITAL WEST DR |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106-8117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528322534 | Kristian Holmes Stodghill | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106 | 2012-06-25 |
| 1942593959 | Wellstar Medical Group, LLC | Family Medicine | 4040 Hospital West Dr, Austell, GA 30106-8117 | 2011-05-24 |
| 1164725776 | Denise J. Wright | Nurse Practitioner | 4040 Hospital West Dr, Austell, GA 30106-8117 | 2010-12-21 |
| 1770803942 | Manouchka Tulia Joseph | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106 | 2010-06-10 |
| 1093042822 | Lashonte Thomas-shaw | Nurse Practitioner | 4040 Hospital West Dr, Austell, GA 30106-8117 | 2009-11-16 |
| 1811135056 | Pamela Gordon | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106 | 2009-01-27 |
| 1063680049 | Wellstar Palliative Medicine, LLC | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106-8117 | 2008-02-13 |
| 1396966016 | Anjali Parmar Grandhige | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106 | 2007-05-01 |
| 1376767731 | Glenora Mccoy | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106-8117 | 2007-04-13 |
| 1609906973 | Walisa K Maynard | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106-8117 | 2007-03-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126231 | Courtney Lashune Dorsett | Nurse Practitioner | 1005 Cureton Drive, Austell, Austell, GA 30106 | 2020-08-27 |
| 1184240491 | Brian H Eves | Dietitian, Registered | 3972 Brantley Drive, Austell, GA 30106 | 2020-06-23 |
| 1669014486 | Jesse Mccoy | Registered Nurse | 3950 Austell Rd., Austell, GA 30106 | 2019-10-14 |
| 1427522820 | Envision Optics LLC | Optometrist | 1680 E West Connector, Austell, GA 30106 | 2019-01-18 |
| 1972042380 | Thomas Dental Group | Clinic/Center | 1133 East West Connector, Suite 120, Austell, GA 30106 | 2017-02-17 |
| 1245779792 | Colton Dental Group | Clinic/Center | 2495 East-west Connector, Ste 60, Austell, GA 30106 | 2017-02-16 |
| 1144691684 | Georgia Dental Professionals, PC | Dentist | 780 East West Connector Sw, Suite 108, Austell, GA 30106 | 2015-10-09 |
| 1285013714 | Ikeade Bello Alamu | Nurse Practitioner | 2870 Betula Drive, Austell, GA 30106 | 2015-05-29 |
| 1376922211 | Jessica Williams | Obstetrics & Gynecology | 1700 Hospital South Dr Ste 500, Austell, GA 30106 | 2015-05-26 |
| 1558799593 | Tonya Renee Baldwin | Speech-Language Pathologist | 4229 Brass Trl., Austell, GA 30106 | 2013-10-30 |
| Find all providers in zip 30106 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801281654 | Accord Hospice of Atlanta | Hospice Care, Community Based | 2740 Jefferson St, Suite A5, Austell, GA 30168-4014 | 2015-03-30 |
| 1407894504 | Pruitthealth Hospice, Inc. | Hospice Care, Community Based | 1676 Mulkey Road, Suites 103, Austell, GA 30106-1170 | 2006-06-02 |
| 1770544116 | Hillcrest Hospice, Inc | Hospice Care, Community Based | 5990 Love St, Austell, GA 30168-4029 | 2006-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153492 | Legacy Hospice Ga | Hospice Care, Community Based | 1700 Frederica Rd Ste 205, St Simons Island, GA 31522-2583 | 2020-10-28 |
| 1013515030 | Perimeter Hospice of Georgia | Hospice Care, Community Based | 150 Stanley Ct Ste E, Lawrenceville, GA 30046-5215 | 2020-10-12 |
| 1780291039 | Goldencare Hospice and Palliative Care | Hospice Care, Community Based | 7555 Bridgegate Ct, Sandy Springs, GA 30350-4604 | 2020-09-29 |
| 1255947651 | Community Hospice of Georgia | Hospice Care, Community Based | 321 N Main St Ste A, Adairsville, GA 30103-2403 | 2020-09-21 |
| 1437762382 | Allaway Angels | Hospice Care, Community Based | 805 Deerfield Ct, Stone Mountain, GA 30087-5483 | 2020-08-28 |
| 1144832494 | Circle of Hope Hospice | Hospice Care, Community Based | 5750 Brook Hollow Pkwy Ste 105, Norcross, GA 30071-3515 | 2020-08-18 |
| 1518578335 | Jaslinks Hospice Inc | Hospice Care, Community Based | 2282 Meadow Church Rd Ste 300, Duluth, GA 30097-5318 | 2020-08-14 |
| 1104434570 | An Angels Touch Hospice LLC | Hospice Care, Community Based | 2345 4th St Ste 600d, Tucker, GA 30084-8518 | 2020-07-21 |
| 1609494327 | Divine Guardian LLC | Hospice Care, Community Based | 2321 4th St Ste 210, Tucker, GA 30084-8516 | 2020-07-09 |
| 1184242026 | Champions Nursing Services, LLC | Hospice Care, Community Based | 2365 Wall St Se Ste 210, Conyers, GA 30013-2197 | 2020-07-07 |
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| 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.