Paul Lawrence Douglass, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

019205 Issued in GA

Practice address

4441 Atlanta Rd SE Ste 213
Smyrna, GA 30080-6442

Phone

(470) 956-9480

NPI assigned

Sep 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)

Education

Meharry Medical College School of Medicine, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
• Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
• Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pdouglass123323@directwellstar.org

All facility ownership & control disclosures 20

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 20

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Au Medical Center, Inc

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1437135902

  Corporate Director

  CMS ownership
• Cobb Hospital, Inc

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448

  Corporate Director

  CMS ownership
• Cobb Hospital, Inc

  • Rehabilitation Hospital Unit
  • Austell, GA
  • NPI 1619967494

  Corporate Director

  CMS ownership
• Douglas Hospital, Inc.

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974

  Corporate Director

  CMS ownership
• Kennestone Hospital, Inc

  • Rehabilitation Hospital Unit
  • Marietta, GA
  • NPI 1578553343

  Corporate Director

  CMS ownership
• Kennestone Hospital, Inc.

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626

  Corporate Director

  CMS ownership
• Kennestone Hospital, Inc.

  • Long Term Care Hospital
  • Marietta, GA
  • NPI 1700853041

  Corporate Director

  CMS ownership
• Paulding Medical Center, Inc.

  • General Acute Care Hospital
  • Hiram, GA
  • NPI 1457329435

  Corporate Director

  CMS ownership
• Wellstar Community Hospice, LLC

  • Community Based Hospice Care Agency
  • Austell, GA
  • NPI 1407811060

  Corporate Director

  CMS ownership
• Wellstar Home Health, LLC

  • Home Health Agency
  • Marietta, GA
  • NPI 1073591376

  Corporate Director

  CMS ownership
• Wellstar MCG Health Warm Springs, Inc.

  • Long Term Care Hospital
  • Warm Springs, GA
  • NPI 1427468362

  Corporate Director

  CMS ownership
• Wellstar MCG Health Warm Springs, Inc.

  • Rehabilitation Hospital
  • Warm Springs, GA
  • NPI 1760892657

  Corporate Director

  CMS ownership

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003

  GA

  Medicare reassignment Care Compare group NPD
• Metropolitan Atlanta Cardiology Consultants

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1285771253

  Cardiovascular Disease, GA

  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  Care Compare group NPD
• Wellstar Medical Group, LLC

  • Hospitalist Physician
  • Marietta, GA
  • NPI 1396033692
  NPD
• Morehouse Healthcare, Inc.

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1801832324

  Cardiovascular Disease

  NPD (past)

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

• Cobb Hospital, Inc

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448

  Hospital

  Care Compare affiliation
• Douglas Hospital, Inc.

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974

  Hospital

  Care Compare affiliation
• Kennestone Hospital, Inc.

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626

  Hospital

  Care Compare affiliation
• Wellstar North Fulton Hospital, Inc

  • General Acute Care Hospital
  • Roswell, GA
  • NPI 1750312997

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1063406262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4441 ATLANTA RD SE STE 213",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806442",
            "telephone_number": "470-956-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 ATLANTA RD SE STE 213",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806442",
            "telephone_number": "470-956-9480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "999 Peachtree St",
            "address_2": "Suite 850",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303093915",
            "country_code": "US",
            "telephone_number": "404-874-1788",
            "fax_number": "404-872-4589",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "999 Peachtree St",
            "address_2": "Suite 850",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303093915",
            "country_code": "US",
            "telephone_number": "404-874-1788",
            "fax_number": "404-872-4589",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "229 Peachtree St NE Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30303",
            "country_code": "US",
            "telephone_number": "404-874-1788",
            "fax_number": "404-872-4589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "PAUL",
        "middle_name": "LAWRENCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "019205",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "019205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060017368/CM0845",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00241788A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pdouglass123323@directwellstar.org",
            "affiliation": "N",
            "address_1": "229 Peachtree St NE Ste 1200",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303031620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeny Fernanda Dominguez Castillo
• Kimberly Lynn Domon
• Donald F. Marshall D.D.S. P.C.
• Martha Louise Dorsey, PH.D.
• Nichole Douglass, RN
• Samantha Dove, DPT
• Rebecca Downes, RPH
• Dietria L Downs, RD, LD
• Mark Candler Doyal, CCC-SLP
• Drawbridge Medical LLC

• All providers in Smyrna, GA
• Interventional Cardiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.

Verify at the official NPI Registry.