Kevin Ward (NPI# 1780934760, PAC ID# 5496042368) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1780934760 |
| PAC ID by PECOS | 5496042368 |
| Professional Enrollment ID | I20170826000337 |
| Full Name | Kevin Ward |
| Organization Legal Name | WELLSTAR MEDICAL GROUP, LLC |
| Address |
6095 Professional Pkwy Suite 100 Douglasville GA 30134-5607 |
| Phone Number | 7709202255 |
| Gender | M |
| Medical School | PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2012 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 6709065402 |
| Number of Group Practice Members | 1320 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110184 | WELLSTAR DOUGLAS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 6095 Professional Pkwy, Suite 100, Douglasville, GA 30134-5607 | 7709202255 | WELLSTAR MEDICAL GROUP, LLC |
| Organization Legal Name | WELLSTAR MEDICAL GROUP, LLC |
| Physicians | 1338 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Phong Hoang Do | Family Medicine | Wellstar Medical Group, LLC | 5150 Stilesboro N W Rd, Suite 220, Kennesaw, GA 30152-7742 |
| Francheska Desravines Alcide | Family Medicine | Wellstar Medical Group, LLC | 687 Marietta Hwy, Canton, GA 30114-2608 |
| Marcus J Gates | Neurosurgery | Wellstar Medical Group, LLC | 625 Church Nest, Marietta, GA 30060-1101 |
| Nimota A Adeboye | Nurse Practitioner | Wellstar Medical Group, LLC | 3886 Princeton Lakes Way Sw, Atlanta, GA 30331-5511 |
| Vanessa Jill Lancaster | Nurse Practitioner | Wellstar Medical Group, LLC | 1360 Upper Hembree Rd, Roswell, GA 30076-1230 |
| Janna Williams-pitts | Psychologist, Clinical | Wellstar Medical Group, LLC | 3805 Cherokee Nwst, Kennesaw, GA 30144-2085 |
| Abhishek Kumar Singh | Family Medicine | Wellstar Medical Group, LLC | 121 Marble Mill N W Rd, Suite 101, Marietta, GA 30060-7959 |
| Khuram Ashraf | Internal Medicine | Wellstar Medical Group, LLC | 6043 Prestley Mill Rd C, Douglasville, GA 30134-2280 |
| Jonathan Noel Dodd | Psychologist, Clinical | Wellstar Medical Group, LLC | 3939 Roswell Rd, Marietta, GA 30062-6285 |
| Matthew Charles Agan | Neurology | Wellstar Medical Group, LLC | 780 Canton Rd Ne, Suite 400, Marietta, GA 30060-7298 |
| Street Address |
6095 PROFESSIONAL PKWY SUITE 100 |
| City | DOUGLASVILLE |
| State | GA |
| Zip | 30134-5607 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shannon L Colvin | Certified Nurse Midwife (cnm) | Wellstar Medical Group, LLC | 6095 Professional Pkwy, A210, Douglasville, GA 30134-5611 |
| Rafiq El Hammali | Nephrology | 6095 Professional Pkwy, B210, Douglasville, GA 30134-5607 | |
| John Justus Miller | Ophthalmology | Georgia Retina, PC | 6095 Professional Pkwy, B202, Douglasville, GA 30134-5629 |
| Kristine Marie Raynard | Certified Nurse Midwife (cnm) | Wellstar Medical Group, LLC | 6095 Professional Pkwy, A210, Douglasville, GA 30134-5611 |
| Marie-teresa Christophe Colbert | Obstetrics/gynecology | Wellstar Medical Group, LLC | 6095 Professional Pkwy, A210, Douglasville, GA 30134-5611 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Frank Paine | Certified Registered Nurse Anesthetist (crna) | Gastroenterology Anesthesia Associates, LLC | 885 Hospital Dr, Suite 102, Douglasville, GA 30134 |
| Jennifer L Hayes | Certified Registered Nurse Anesthetist (crna) | Gastroenterology Anesthesia Associates, LLC | 885 Hospital Dr, Suite 102, Douglasville, GA 30134 |
| Lucy Schmidt Sugg | Certified Registered Nurse Anesthetist (crna) | Gastroenterology Anesthesia Associates, LLC | 885 Hospital Dr, Suite 102, Douglasville, GA 30134 |
| Rhona A Hyman | Nurse Practitioner | Wellstar Medical Group, LLC | 9280 Hwy 5 H, Douglasville, GA 30134-1501 |
| Albert M Edwards | Family Medicine | 9280 Hwy 5 D, Douglasville, GA 30134-1501 | |
| Mohamad A Hamki | Emergency Medicine | Prime Immediate Care LLC | 9280 Hwy 5 E, Douglasville, GA 30134-1501 |
| Dominic I Asika | Emergency Medicine | Prime Immediate Care LLC | 9280 Hwy 5 E, Douglasville, GA 30134-1501 |
| Michelle Huggins | Internal Medicine | 6934 Hwy 78, Douglasville, GA 30134-1604 | |
| David M Lebhaft | Chiropractic | 6602 Church St, Douglasville, GA 30134-1808 | |
| Michael Shannon Moody | Family Medicine | 8464 Adair St, Douglasville, GA 30134-1839 | |
| Find all physicians in zip 30134 | |||
| City | DOUGLASVILLE |
| Zip Code | 30134 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | DOUGLASVILLE + OBSTETRICS/GYNECOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.