Wellstar Surgical Associates of Marietta

Primary specialty

Critical Access HospitalTaxonomy code 282NC0060X

License

RN175391 Issued in GA

Legal business name

WELLSTAR SURGICAL ASSOCIATES OF MARIETTA

Practice address

55 Whitcher St NE Ste 130
Marietta, GA 30060-1156

Phone

(770) 428-0462

Fax

(770) 428-0462

NPI assigned

Apr 15, 2014

Last updated

Apr 16, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Anita Joyce Johnson, NP

Title

Nurse Practitioner

Phone

(770) 428-0462

Specialties & licenses 1

Addresses

Other names 1

• Wellstar Hospital Kennestone Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397606400000",
    "number": "1003235383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 APPLEWOOD LN",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301012625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE STE 130",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601156",
            "telephone_number": "770-428-0462",
            "fax_number": "770-428-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR SURGICAL ASSOCIATES OF MARIETTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "JOYCE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "770-428-0462",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "GA",
            "license": "RN175391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellstar Hospital Kennestone",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Wellstar Professional Services, LLC
• Wellstar Psychiatry, LLC
• Wellstar Rehab Medicine, LLC
• Wellstar Rheumatology Associates of Marietta, LLC
• Wellstar Shallowford Medical Center, LLC
• Wellstar Surgical Associates of Marietta, LLC
• Wellstar Thoracic Surgery Associates, LLC
• Wellstar Urgent Care on Delk Road, LLC
• Wellstar Urgent Care on Sandy Plains Road, LLC
• Wellstar West Cobb Medical Center, LLC

• Critical Access Hospital in Marietta, GA
• Providers in Marietta, GA by specialty
• Critical Access Hospital in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.