WELLSTAR MEDICAL GROUP, LLC (NPI# 1942593959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942593959 |
| Entity Type | Organization |
| Organization Name | WELLSTAR MEDICAL GROUP, LLC |
| Other Organization Name | WELLSTAR PALLIATIVE MEDICINE |
| Practice Address |
4040 Hospital West Dr Austell GA 30106-8117 |
| Practice Telephone | 7707326798 |
| Practice Fax Number | 7707326732 |
| Mailing Telephone | 7707326798 |
| Mailing Fax Number | 7707326732 |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2013-11-18 |
| 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 | 207QH0002X |
Family Medicine Specialization: Hospice and Palliative Medicine |
GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WellStar Palliative Medicine | 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 |
4040 HOSPITAL WEST DR |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106-8117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407811060 | Wellstar Community Hospice, LLC | Hospice Care, Community Based | 4040 Hospital West Dr, Austell, GA 30106-8117 | 2006-04-18 |
| 1528322534 | Kristian Holmes Stodghill | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106 | 2012-06-25 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 207QH0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Hospice and Palliative Medicine |
| A family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care. |
| Notes: Source: American Academy of Hospice and Palliative Medicine, www.aahpm.org [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548501000 | Bethany Hospice and Palliative Care of Coastal Georgia, LLC | Family Medicine | 8395 Us Highway 301, Claxton, GA 30417-5992 | 2013-03-08 |
| 1205121811 | Ceveland Thompson IIi | Family Medicine | 208 Plantation Dr, Waycross, GA 31501-4269 | 2011-06-10 |
| 1538339726 | Alice Irene Lawver | Family Medicine | 2362 Lawrenceville Highway, Decatur, GA 30033 | 2008-03-04 |
| 1285284893 | Affinity Acquisitions Georgia LLC | Family Medicine | 12 Sammy Mcghee Blvd Ste 202, Jasper, GA 30143-7712 | 2019-09-16 |
| 1013485382 | Alisha Dalila Springer | Family Medicine | 500 Osigian Blvd, Warner Robins, GA 31088-8995 | 2018-11-05 |
| 1194230763 | Grace Hospice Services LLC | Family Medicine | 2398 Lenora Church Rd, Snellville, GA 30078-6921 | 2017-12-05 |
| 1205380995 | Seasons Medical Group of Georgia PC | Family Medicine | 5775 Peachtree Dunwoody Rd Ne, Suite C120, Atlanta, GA 30342-1501 | 2016-08-10 |
| 1871968511 | Prime By Aseracare LLC | Family Medicine | 1117 Perimeter Ctr, N500, Atlanta, GA 30338-5451 | 2015-12-07 |
| 1366671711 | Jesse Ann Soodalter | Family Medicine | 550 Peachtree St Ne, Atlanta, GA 30308 | 2009-07-07 |
| 1063665834 | South Georgia Family Medicine Associates | Family Medicine | 1203 Brampton Ave, Statesboro, GA 30458-0850 | 2008-10-24 |
| Find all providers with the same taxonomy | ||||
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.