NPIMap

Individual provider Active NPI

Gary Marc Wetherington, MD

  • Plastic and Reconstructive Surgery Physician
  • Rome, GA
National Provider Identifier
1073678066
Registry record updated Feb 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
030690 Issued in GA
Practice address
506 Riverside Pkwy NE
Suite 200
Rome, GA 30161-2902
Phone
(706) 291-4334
Fax
(706) 291-0248
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 030690 GA Primary

Addresses

Primary practice location

506 Riverside Pkwy NE
Suite 200
Rome, GA 30161-2902

Mailing address

PO Box 468
Rome, GA 30162-0468
Phone (706) 291-4334

Other identifiers 2

IdentifierTypeStateIssuer
000393137AMedicaidGA
000393137BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060111000846 GA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Family Practice 7911920376 Reassigns benefits to 1 organization
I20230726001769 AL Practitioner - Plastic and Reconstructive Surgery 7911920376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Family Practice
Education
University of South Florida College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Floyd Healthcare Management IncGroup PAC ID 5193633386, 133 clinicians

Practice addresses (Care Compare)

304 Turner McCall Blvd SW
Rome, GA 30165-5621
Phone (706) 509-5000

400 Northwodd Dr
Centre, AL 35960-1023
Phone (256) 927-5531

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue91
Removal of skin lesions28
Removal of nail tissue73
Removal or shaving of skin growth25
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
030690GAMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd Cherokee Medical Center LLC Current Accepting new patients
Floyd Healthcare Management Inc CurrentSince May 1, 2023 Accepting new patients
Floyd Healthcare Management Inc CurrentSince May 1, 2023 Accepting new patients

Locations

400 Northwood Dr
Centre, AL 35960
Phone (256) 927-1382

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

330 Turner McCall Blvd SW
Ste 206
Rome, GA 30165
Phone (706) 509-6834

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

330 Turner McCall Blvd SW
Ste 30
Rome, GA 30165

330 Turner McCall Blvd SW
Ste 306
Rome, GA 30165
Phone (706) 509-6815

420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235433600000",
    "number": "1073678066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 468",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301620468",
            "telephone_number": "706-291-4334",
            "fax_number": "706-291-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 RIVERSIDE PKWY NE",
            "address_2": "SUITE 200",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301612902",
            "telephone_number": "706-291-4334",
            "fax_number": "706-291-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETHERINGTON",
        "first_name": "GARY",
        "middle_name": "MARC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2009-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "GA",
            "license": "030690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000393137A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000393137B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.