WELLSTAR CARDIOVASCULAR MEDICINE, LLC (NPI# 1427333293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427333293 |
| Entity Type | Organization |
| Organization Name | WELLSTAR CARDIOVASCULAR MEDICINE, LLC |
| Practice Address |
720 Transit Ave Suite 102 Canton GA 30114-2540 |
| Mailing Address |
55 Whitcher St Ne Suite 350 Marietta GA 30060-1155 |
| Practice Telephone | 7707041955 |
| Practice Fax Number | 7707202388 |
| Mailing Telephone | 7704246893 |
| Mailing Fax Number | 7705289938 |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2012-05-09 |
| Authorized Official Name | DR. BARRY D MANGEL (CJIEF CARDIOLOGY OFFICER) |
| Authorized Official Telephone | 7704246893 |
| Is Organization Subpart | Y |
| Parent Organization Name | WELLSTAR HEALTH SYSTEM, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 386693863A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205195724 | Wellstar Cardiovascular Medicine, LLC | Internal Medicine | 40 Fox Chase, Cartersville, GA 30120-2491 | 2012-05-04 |
| 1902183742 | Wellstar Cardiovascular Medicine, LLC | Internal Medicine | 699 Church St Ne, Suite 240, Marietta, GA 30060-1110 | 2011-11-08 |
| 1992082739 | Wellstar Cardiovascular Medicine, LLC | Internal Medicine | 700 Church St Ne, Marietta, GA 30060-7220 | 2011-11-08 |
| 1427333277 | Wellstar Cardiovascular Medicine, LLC | Internal Medicine | 6001 Professional Pkwy, Suite 2080, Douglasville, GA 30134-5631 | 2011-10-12 |
| 1659656403 | Wellstar Cardiovascular Medicine, LLC | Internal Medicine | 148 Bill Carruth Pkwy, Suite 100, Hiram, GA 30141-3754 | 2011-10-12 |
| 1750666525 | Wellstar Cardiovascular Medicine, LLC | Internal Medicine | 1010 Johnson Ferry Rd, Marietta, GA 30068-2108 | 2011-10-12 |
| 1811272693 | Wellstar Cardiovascular Medicine, LLC | Internal Medicine | 120 Stonebridge Pkwy, Suite 110, Woodstock, GA 30189-3767 | 2011-10-12 |
| 1770868531 | Wellstar Cardiovascular Medicine, LLC | Internal Medicine | 4900 Ivey Rd Nw, Bldg 1800 Suite 1801, Acworth, GA 30101-4001 | 2011-10-12 |
| 1639454408 | Wellstar Cardiovascular Medicine, LLC | Internal Medicine | 12 Sammy Mcghee Blvd, Suite 202, Jasper, GA 30143-7711 | 2011-10-12 |
| 1952686826 | Wellstar Cardiovascular Medicine, LLC | Internal Medicine | 1700 Hospital South Dr, Suite 409, Austell, GA 30106-6810 | 2011-10-11 |
| Street Address |
720 TRANSIT AVE SUITE 102 |
| City | CANTON |
| State | GA |
| Zip Code | 30114-2540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548219330 | Charles R Cooley | Family Medicine | 720 Transit Ave, Suite 101, Canton, GA 30114-2571 | 2006-05-09 |
| 1942761150 | Robert Breingan | Physical Therapist | 720 Transit Ave, Canton, GA 30114-2540 | 2019-03-29 |
| 1699104554 | Valerie Ciesla | Physical Therapist | 720 Transit Ave, Suite 202, Canton, GA 30114-2540 | 2013-11-01 |
| 1316298953 | Bethany Wiley Lill | Physician Assistant | 720 Transit Ave, Suite 202, Canton, GA 30114-2540 | 2012-09-22 |
| 1184864258 | Kennestone Heart Physicians Group, PC | Internal Medicine | 720 Transit Ave, Building 100, Suite 102, Canton, GA 30114-2540 | 2009-03-02 |
| 1740448372 | Physicians Family Medicine of Canton, LLC | Clinic/Center | 720 Transit Ave, Ste 101, Canton, GA 30114-2571 | 2008-05-30 |
| 1053453852 | Pinnacle Orthopaedics & Sports Medicine Specialists LLC | Orthopaedic Surgery | 720 Transit Ave, Suite 202, Canton, GA 30114 | 2007-02-12 |
| 1306921226 | Physiotherapy Associates Inc | Clinic/Center | 720 Transit Ave, Suite 102, Canton, GA 30114-2571 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619516093 | Wickshire Canton Opco LLC | Assisted Living Facility | 125 Riverstone Terrace, Canton, GA 30114 | 2020-01-02 |
| 1154803583 | Alixandra Nicole Flournoy | Physical Therapist | 131 Holly Street, Canton, GA 30114 | 2018-09-01 |
| 1588157341 | Provident Group - Canton Cove Properties LLC | Alzheimer Center (Dementia Center) | 1100 Reinhardt College Parkway, Canton, GA 30114 | 2018-06-07 |
| 1003233107 | Heartland Dental Care of Georgia | Dentist | 3237 Sixes Rd, Canton, GA 30114 | 2014-03-26 |
| 1730510959 | Joseph Optical | Eyewear Supplier (Equipment, not the service) | 1455 Riverstone Pkwy Suite 110, Canton, GA 30114 | 2013-12-13 |
| 1629313036 | Ramona Morton Rasmussen | Occupational Therapist | 200 Riverstone Drive, Suite B, Canton, GA 30114 | 2012-12-11 |
| 1902154875 | Yong Qiao Luo | Acupuncturist | 200 Oakside Lane, Suite D, Canton, GA 30114 | 2012-08-26 |
| 1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
| 1558638981 | Stephen E Byrd | Counselor | 191 Lamar Haley Pkwy., Canton, GA 30114 | 2011-11-30 |
| 1073807855 | Sheri Sullins Buckley | Nurse Practitioner | 120 Oakside Ct Ste H, Canton, GA 30114 | 2011-06-08 |
| Find all providers in zip 30114 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982168100 | Optimum Cardiology Inc | Internal Medicine | 4825 Higbee Ave Nw Ste 102, Canton, OH 44718-2567 | 2019-01-23 |
| 1861716508 | Premier Diagnostics PC | Internal Medicine | 48492 Inveraray Rd, Canton, MI 48188 | 2010-03-24 |
| 1477593572 | Daniel Andrew Pietro | Internal Medicine | 19 Hunter Ln, Canton, MA 02021-1731 | 2006-06-07 |
| 1114997822 | Mohamad Hikmat Kabbani | Internal Medicine | 2050 N Haggerty Rd Ste 200, Canton, MI 48187-3796 | 2006-01-25 |
| 1548269756 | David J. Utlak | Internal Medicine | 4455 Dressler Rd Nw, Canton, OH 44718-2769 | 2005-07-19 |
| 1487653986 | Stephen W Pipoly | Internal Medicine | 1330 Mercy Drive Nw, Suite 410, Canton, OH 44708 | 2005-07-18 |
| 1154329928 | Kirk B Laman | Internal Medicine | 15 Reinhardt College Pkwy, Suite 110, Canton, GA 30114-5257 | 2005-07-14 |
| 1205126851 | Anjan Deka | Internal Medicine | 460 Northside Cherokee Blvd Ste 190, Canton, GA 30115-8018 | 2011-04-17 |
| 1306086228 | Kennestone Heart Physicians Group | Internal Medicine | 200 Oakside Ln, Suite D, Canton, GA 30114-6416 | 2009-03-05 |
| 1184864258 | Kennestone Heart Physicians Group, PC | Internal Medicine | 720 Transit Ave, Building 100, Suite 102, Canton, GA 30114-2540 | 2009-03-02 |
| Find all providers in CANTON | ||||
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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.