WELLSTAR MEDICAL GROUP, LLC (NPI# 1588059653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588059653 |
| Entity Type | Organization |
| Organization Name | WELLSTAR MEDICAL GROUP, LLC |
| Other Organization Name | WELLSTAR FAMILY MEDICINE (CARTERSVILLE) |
| Practice Address |
12 Medical Dr Ne Cartersville GA 30121-8002 |
| Practice Telephone | 7703861000 |
| Practice Fax Number | 7703869165 |
| Mailing Telephone | 7703861000 |
| Mailing Fax Number | 7703869165 |
| Enumeration Date | 2015-04-05 |
| Last Update Date | 2015-04-05 |
| 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 | 207Q00000X | Family Medicine | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WellStar Family Medicine (Cartersville) | 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 |
| 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 |
12 MEDICAL DR NE |
| City | CARTERSVILLE |
| State | GA |
| Zip Code | 30121-8002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619993102 | C. Thomas Bevill IIi | Family Medicine | 12 Medical Dr Ne, Cartersville, GA 30121-8002 | 2006-07-15 |
| 1497082499 | Abigail Leigh Matthews | Physician Assistant | 12 Medical Dr Ne, Cartersville, GA 30121-8002 | 2009-11-11 |
| 1518089820 | C. Thomas Bevill IIi Md, PC | Family Medicine | 12 Medical Dr Ne, Cartersville, GA 30121-8002 | 2007-04-06 |
| 1760408272 | J Michael Williams | Family Medicine | 12 Medical Dr Ne, Cartersville, GA 30121-8002 | 2006-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639700065 | Emilee Mcdonald Thomas | Pharmacist | 125 E Main Street Marketplace, Cartersville, GA 30121 | 2020-02-04 |
| 1245750249 | Gina Marie Hoosline | Contractor | 38 Roving Rd Se, Cartersville, GA 30121 | 2017-06-21 |
| 1730634239 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 125 E Main St Se, Cartersville, GA 30121 | 2016-08-25 |
| 1811340797 | Pt Solutions of Acworth LLC | Physical Therapist | 261 Stars Way, Cartersville, GA 30121 | 2016-07-15 |
| 1053572172 | Helen Clair Medlin | Nurse Practitioner | 255 Prosperity Way Ne, Adairsville, GA 30121 | 2008-06-20 |
| 1669539508 | The Healthcaring Clinic of Georgia, LLC | Nurse Practitioner | 491 East Main St., Cartersville, GA 30121 | 2007-01-02 |
| 1275636334 | Medicine Stop Pharmacy | Pharmacy | 117 S Tennessee St, Cartersville, GA 30121 | 2006-09-06 |
| 1750494423 | Georgia Pain Spine Center | Clinic/Center | 15 Medical Drive, Suite 302, Cartersville, GA 30121 | 2006-08-16 |
| 1932138716 | Cartersville Diagnostic Center | Clinic/Center | 21 Pointe North Drive, Suite 105, Cartersville, GA 30121 | 2006-07-02 |
| 1689663825 | Howard Jamie Williams | Physician Assistant | 15 Medical Dr Ne Ste 101, Cartersville, GA 30121 | 2005-10-20 |
| Find all providers in zip 30121 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558628701 | Jerry Mark Wigley Md | Family Medicine | 179 Pine Grove Rd, Suite B, Cartersville, GA 30120-8422 | 2012-04-12 |
| 1669642484 | Louis Spencer | Family Medicine | 650 Henderson Drive Suite 504, Cartersville, GA 30120 | 2008-03-07 |
| 1558495929 | Timothy F Ryan | Family Medicine | 150 Cherokee Cir Se, Cartersville, GA 30120-4032 | 2007-03-15 |
| 1265560031 | Joseph Paul Newell | Family Medicine | 519 Waterford Dr, Cartersville, GA 30120-6444 | 2007-03-01 |
| 1922156462 | Benjamin R Smith | Family Medicine | 17 Collins Dr, Cartersville, GA 30120-2487 | 2007-01-08 |
| 1336152396 | Celedor Hutto Akintunde | Family Medicine | 31 Pointe North Dr, Cartersville, GA 30120-7954 | 2006-08-14 |
| 1699794818 | Jerry Mark Wigley | Family Medicine | 179b Pine Grove Rd., Cartersville, GA 30120 | 2006-07-19 |
| 1619993102 | C. Thomas Bevill IIi | Family Medicine | 12 Medical Dr Ne, Cartersville, GA 30121-8002 | 2006-07-15 |
| 1316986227 | Cartersville Urgent Care LLC | Family Medicine | 824 West Ave, Cartersville, GA 30120-6100 | 2006-06-06 |
| 1962460659 | Cartersville Family Medicine, Inc. | Family Medicine | 2294 Cartersville Rd, Cartersville, VA 23027-9701 | 2006-05-02 |
| Find all providers in CARTERSVILLE | ||||
| City | CARTERSVILLE |
| Zip Code | 30121 |
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.