Active NPI
Vanchad C Memark, M.D.
- Surgery Physician
- Hiram, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 64416
- Practice address
- 148 Bill Carruth Pkwy
Suite 180
Hiram, GA 30141-3754 - Phone
- (770) 445-4915
- Fax
- (770) 445-2876
- NPI assigned
- Nov 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 64416 | GA | Primary |
Addresses
Primary practice location
148 Bill Carruth Pkwy
Suite 180
Hiram, GA 30141-3754
Mailing address
148 Bill Carruth Pkwy
Suite 180
Hiram, GA 30141-3754
Phone (770) 445-4915
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2949877 | Medicaid | OH |
Other names 1
- Ron C Memark
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Loyola University of Chicago, Stritch School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
148 Bill Carruth Pkwy
Hiram, GA 30141-3756
2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068
Phone (770) 732-4022
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
Hospital & facility affiliations
- Wellstar Paulding Medical Center
- Wellstar Cobb Medical Center
- Wellstar Kennestone Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 14 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64416 | GA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Cardiovascular Medicine, LLC | Past | Accepting new patients | |
| Wellstar Medical Group, LLC | Surgery | Past | Accepting new patients |
Locations
4904 Timber Ridge Dr
Ste 104
Douglasville, GA 30135
Phone (770) 942-4822
6002 Professional Pkwy
Ste 260
Douglasville, GA 30134
Phone (470) 644-5411
148 Bill Carruth Pkwy
Ste 180
Hiram, GA 30141
Phone (770) 445-1915
5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
Networks
- devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
- AL HMO
- devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
- devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
- AL HMO D-SNP
Interoperability endpoints
- vmemark24549@directwellstar.org
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
-
- Cardiovascular Disease Physician
- Marietta, GA
- NPI 1457320319
-
- Surgery Physician
- Douglasville, GA
- NPI 1164715132
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Austell, GA
- NPI 1467420448
-
- General Acute Care Hospital
- Marietta, GA
- NPI 1649248626
-
- General Acute Care Hospital
- Hiram, GA
- NPI 1457329435
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485734400000",
"number": "1013196492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 BILL CARRUTH PKWY",
"address_2": "SUITE 180",
"city": "HIRAM",
"state": "GA",
"postal_code": "301413754",
"telephone_number": "770-445-4915",
"fax_number": "770-445-2876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "148 BILL CARRUTH PKWY",
"address_2": "SUITE 180",
"city": "HIRAM",
"state": "GA",
"postal_code": "301413754",
"telephone_number": "770-445-4915",
"fax_number": "770-445-2876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEMARK",
"first_name": "VANCHAD",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-01",
"last_updated": "2017-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GA",
"license": "64416",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2949877",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "RON",
"last_name": "MEMARK",
"middle_name": "C",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Hiram, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.