WELLSTAR MEDICAL GROUP, LLC (NPI# 1558667691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558667691 |
| Entity Type | Organization |
| Organization Name | WELLSTAR MEDICAL GROUP, LLC |
| Other Organization Name | WELLSTAR EAST PAULDING PEDIATRIC CENTER |
| Practice Address |
51 Hiram Dr Building B Hiram GA 30141-1844 |
| Practice Telephone | 6789458300 |
| Practice Fax Number | 7704452060 |
| Mailing Telephone | 6789458300 |
| Mailing Fax Number | 7704452060 |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2013-11-19 |
| Authorized Official Name | MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 4706440095 |
| Is Organization Subpart | Y |
| Parent Organization Name | WELLSTAR MEDICAL GROUP, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WellStar East Paulding Pediatric Center | Doing Business As Name - Organization |
| 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 |
| 1275992240 | Wellstar Medical Group, LLC | Clinic/Center | 805 Sandy Plains Rd, Marietta, GA 30066-6340 | 2016-02-18 |
| 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 |
| Street Address |
51 HIRAM DR BUILDING B |
| City | HIRAM |
| State | GA |
| Zip Code | 30141-1844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396738381 | Wellstar Medical Group East Paulding Pediatrics | Specialist | 51 Hiram Dr, Hiram, GA 30141-1844 | 2005-08-25 |
| 1043665243 | Sara Hunlock Temple | Nurse Practitioner | 51 Hiram Dr, Hiram, GA 30141-1844 | 2016-04-26 |
| 1386926319 | Nicole Marie Mchargue | Nurse Practitioner | 51 Hiram Dr, Hiram, GA 30141-1844 | 2011-09-15 |
| 1801022017 | Nicole B Spitalnick | Nurse Practitioner | 51 Hiram Dr, Building B, Hiram, GA 30141-1844 | 2009-06-02 |
| 1114121704 | Andrea Janel Thames-allen | Pediatrics | 51 Hiram Dr, Bldg B, Hiram, GA 30141-1844 | 2007-06-14 |
| 1841246337 | Wellstar East Paulding Pediatric Center, LLC | Pediatrics | 51 Hiram Dr, Building B, Hiram, GA 30141-1844 | 2006-05-26 |
| 1902896053 | Laura Verigan | Pediatrics | 51 Hiram Dr, Bldg B, Hiram, GA 30141-1844 | 2005-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801255690 | Belinda Lett Baker | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5316 Jones Reserve Walk, Hiram, GA 30141 | 2016-02-22 |
| 1104213339 | Matthew Lee Estes | Nurse Practitioner | 148 Bill Carruth Pkwy Ste 220, Hiram, GA 30141 | 2015-04-26 |
| 1881088649 | Marietta Eye Clinic, Pa | Optometrist | 47 Highland Pavilion Ct, Suite 101, Hiram, GA 30141 | 2015-03-19 |
| 1902217417 | Hiram Dental Group, PC | Dentist | 5218 Jimmy Lee Smith Parkway, Suite 100, Hiram, GA 30141 | 2014-05-19 |
| 1912340613 | Anuj Patel | Orthopaedic Surgery | 148 Bill Carruth Parkway Suite 120, Hiram, GA 30141 | 2013-04-11 |
| 1619280278 | Thomas Wayne Bloodworth | Obstetrics & Gynecology | 6794 Bill Carruth Parkway, Hiram, GA 30141 | 2010-07-23 |
| 1487970026 | Madelynn Lorraine Speach | Counselor | 44 Darbys Crossing Dr Ste 206c, Hiram, GA 30141 | 2010-04-07 |
| 1679760433 | We Care Md, P.C. | Family Medicine | 5610 Wendy Bagwell Parkway, Suite 103, Hiram, GA 30141 | 2007-09-26 |
| 1811188121 | Holly L Watson | Nurse Practitioner | 156 Hiram Drive, Building B, Hiram, GA 30141 | 2007-08-05 |
| 1285842799 | Restoration Physical Therapy, LLC. | Clinic/Center | 5077 Jimmy Lee Smith Pkwy, Suite 119, Hiram, GA 30141 | 2007-05-18 |
| Find all providers in zip 30141 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164415998 | Kelly R Davillier | Pediatrics | 55 Hiram Dr, Building B, Hiram, GA 30141-1844 | 2005-08-26 |
| 1609875343 | Amy Renee Murray | Pediatrics | 51 Hiram Dr Bldg B, Hiram, GA 30141-1844 | 2005-07-15 |
| 1578004842 | Ashley Nicole Williams | Pediatrics | 51 Hiram Dr Bldg B, Hiram, GA 30141-1844 | 2017-03-20 |
| 1689092181 | Ami Natvarlal Dalsania | Pediatrics | 51 Hiram Dr Bldg B, Hiram, GA 30141-1844 | 2014-04-01 |
| 1598930141 | Pinnacle Pediatrics PC | Pediatrics | 5604 Wendy Bagwell Pkwy, Suite 1111, Hiram, GA 30141-7813 | 2008-04-24 |
| 1114121704 | Andrea Janel Thames-allen | Pediatrics | 51 Hiram Dr, Bldg B, Hiram, GA 30141-1844 | 2007-06-14 |
| 1841246337 | Wellstar East Paulding Pediatric Center, LLC | Pediatrics | 51 Hiram Dr, Building B, Hiram, GA 30141-1844 | 2006-05-26 |
| 1841249778 | Kathleen Elizabeth Empen | Pediatrics | 51 Hiram Dr Bldg B, Hiram, GA 30141 | 2006-05-08 |
| 1720065436 | Joanna Dolgoff | Pediatrics | 51 Hiram Dr Bldg B, Hiram, GA 30141 | 2005-12-23 |
| 1902896053 | Laura Verigan | Pediatrics | 51 Hiram Dr, Bldg B, Hiram, GA 30141-1844 | 2005-10-28 |
| Find all providers in HIRAM | ||||
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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.