WELLSTAR MEDICAL GROUP, LLC


Address: 55 Whitcher St Ne, Suite 130, Marietta, GA 30060-1156
Phone: 7704261629

WELLSTAR MEDICAL GROUP, LLC (NPI# 1699065573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1699065573
Entity Type Organization
Organization Name WELLSTAR MEDICAL GROUP, LLC
Other Organization Name WELLSTAR TRAUMA
Practice Address 55 Whitcher St Ne
Suite 130
Marietta
GA 30060-1156
Practice Telephone 7704261629
Practice Fax Number 7704278001
Mailing Telephone 7704261629
Mailing Fax Number 7704278001
Enumeration Date 2011-04-13
Last Update Date 2015-06-05
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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0127X Surgery
Specialization: Trauma Surgery
GA Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
WellStar Trauma Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 55 WHITCHER ST NE
SUITE 130
City MARIETTA
State GA
Zip Code 30060-1156

Providers in the same location

NPI Name Taxonomy Address Enumeration
1730183377 Vijay Nath Specialist 55 Whitcher St Ne, Ste 460, Marietta, GA 30060-1171 2005-06-10
1710452875 Jaleny Abajobir Nurse Practitioner 55 Whitcher St Ne, Marietta, GA 30060-1155 2018-10-04
1366961591 Rachel Alexandra Strickland Nurse Practitioner 55 Whitcher St Ne, Marietta, GA 30060-1155 2017-09-19
1730609850 Rudi Maria Coleman Social Worker 55 Whitcher St Ne, Marietta, GA 30060-1155 2017-06-20
1114451432 Nerma S Mccrary Nurse Practitioner 55 Whitcher St Ne, Suite 460, Marietta, GA 30060-1155 2017-04-13
1215476304 G Nurse Practitioner 55 Whitcher St Ne, Marietta, GA 30060-1155 2017-02-22
1972042117 Joslyn Gross Nurse Practitioner 55 Whitcher St Ne, Ste 160, Marietta, GA 30060-1155 2017-02-21
1639616089 Lonnie Jones Nurse Practitioner 55 Whitcher St Ne, Suite 130, Marietta, GA 30060-1155 2017-01-24
1073059804 Melida Garcia Nurse Practitioner 55 Whitcher St Ne, Suite 350, Marietta, GA 30060-1155 2017-01-18
1528503166 Helen W. James Nurse Practitioner 55 Whitcher St Ne, Suite 350, Marietta, GA 30060-1155 2017-01-05
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144845116 Legacy Center for Spinal Surgery, LLC Neurological Surgery 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 2020-06-15
1407477193 Michael Cynil Daniel Counselor 698 N Marietta, Pkwy, Marietta, GA 30060 2020-05-04
1285253401 Cameron Thomas Kennelly Student in an Organized Health Care Education/Training Program 677 Church Street Ne Attn:gme, Marietta, GA 30060 2020-04-09
1922640739 Jeremiah George Blair Physician Assistant 61 Whitcher St Suite 2100, Marietta, GA 30060 2019-10-14
1164064945 Denise Alicia Mick Registered Nurse 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 2019-10-12
1184283772 Iora Health Georgia, P.C. Internal Medicine 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 2019-06-07
1346703212 Caitlin Virginia Mueller Student in an Organized Health Care Education/Training Program 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 2019-04-08
1184187205 Adero Francis Student in an Organized Health Care Education/Training Program Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 2019-04-08
1659832749 Matthew Mozzo Student in an Organized Health Care Education/Training Program 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 2019-03-29
1245797430 La'myia Spentz Specialist 109 Anderson St Ne, Suite 608, Marietta, GA 30060 2019-02-25
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Taxonomy Information

Taxonomy Code 2086S0127X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Trauma Surgery

Taxonomy Definition

Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.
Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1215248604 James G Boron Surgery 55 Whitcher St Ne Ste 130, Marietta, GA 30060 2010-06-30
1700047784 Keren Aviva Bashan-gilzenrat Surgery 55 Whitcher St Ne Ste 130, Marietta, GA 30060 2008-06-22
1184898223 Nathan Michael Polite Surgery 55 Whitcher St Ne, Suite 130, Marietta, GA 30060-1155 2008-04-18

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1205192424 Nathan John Klingensmith Surgery 69 Jesse Hill Jr Drive, Se, Glenn Memorial Building, 3rd Floor, Atlanta, GA 30303 2012-04-03
1306928809 Kevin J Farrell Surgery 101 West Ponce Deleon Ave, Emory Medical Care Foundation Ste 331, Decatur, GA 30030 2006-10-20
1972503837 Gregory R Strauther Surgery 200 S Enota Dr Ne, Suite 150, Gainesville, GA 30501-3473 2005-07-21
1841583119 Brian H Gibson Surgery 743 Spring St Ne, Gainesville, GA 30501-3715 2011-05-19
1710283460 Malcolm Ingram Goodchild Surgery 2737 Warm Springs Rd, Building A, Columbus, GA 31904-6859 2011-01-28
1427377043 James Clifton Haynes Surgery 2500 Hospital Blvd Ste 290, Roswell, GA 30076-4918 2010-05-21
1790946762 Katherine Kohler Surgery 69 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3033 2008-06-22
1801062773 Nathan Joseph Creel Surgery 743 Spring St Ne, Gainesville, GA 30501-3715 2008-05-01
1205021201 Mitchell Chaar Surgery 80 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3031 2007-09-12
1245456706 Cassandra Quiana White Surgery 1120 15th St, Augusta, GA 30912-0004 2007-04-17
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Competitor

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City MARIETTA
Zip Code 30060

Improve Information

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Dataset Information

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.

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