NPIMap

Individual provider Active NPI

Lataura Atwell-Small, M.D.

  • Family Medicine Physician
  • Hiram, GA
National Provider Identifier
1033474184
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
96679 Issued in GA
Practice address
144 Bill Carruth Pkwy Ste 2200
Hiram, GA 30141-3827
Phone
(470) 956-4250
Fax
(770) 999-2761
NPI assigned
Jul 5, 2012
Last updated
Sep 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME111325 FL
Family Medicine Physician 207Q00000X 96679 GA Primary

Addresses

Primary practice location

144 Bill Carruth Pkwy Ste 2200
Hiram, GA 30141-3827

Mailing address

144 Bill Carruth Pkwy Ste 2200
Hiram, GA 30141-3827
Phone (470) 956-4250

Other practice location 1

620 10th Street N.
St Petersburg, FL 33705-1407
Phone (727) 824-7176

Other identifiers 1

IdentifierTypeStateIssuer
006339100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address latwellsmall528001@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230825002440 GA Practitioner - Family Practice 1355597014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Florida College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

148 Bill Carruth Pkwy
Hiram, GA 30141-3756

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Aug 8, 2023 Accepting new patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients

Locations

144 Bill Carruth Pkwy
Ste 2200
Hiram, GA 30141
Phone (470) 956-3845

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1033474184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 BILL CARRUTH PKWY STE 2200",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301413827",
            "telephone_number": "470-956-4250",
            "fax_number": "770-999-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 BILL CARRUTH PKWY STE 2200",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301413827",
            "telephone_number": "470-956-4250",
            "fax_number": "770-999-2761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 10th Street N.",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337051407",
            "country_code": "US",
            "telephone_number": "727-824-7176",
            "fax_number": "727-824-7173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATWELL-SMALL",
        "first_name": "LATAURA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME111325",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "96679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006339100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "latwellsmall528001@directwellstar.org",
            "affiliation": "N",
            "address_1": "144 Bill Carruth Pkwy Ste 2200",
            "city": "Hiram",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301413827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

Verify at the official NPI Registry.