Individual provider Active NPI

Michelle D. Wigley, LCSW

  • Clinical Social Worker
  • Douglasville, GA
National Provider Identifier
1093243198
Registry record updated Jun 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005747 Issued in GA
Practice address
8820 Hospital Dr
Douglasville, GA 30134-2266
Phone
(770) 947-3000
NPI assigned
Jun 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW005747 GA Primary

Addresses

Primary practice location

8820 Hospital Dr
Douglasville, GA 30134-2266

Mailing address

8820 Hospital Dr
Douglasville, GA 30134-2266

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170812000202 GA Practitioner - Clinical Social Worker 0042581803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
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)

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

8820 Hospital Dr
Douglasville, GA 30134-2266
Phone (770) 947-3000

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

State licenses

LicenseStateTypeSpecialty
CSW005747GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jul 1, 2017 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Jul 1, 2017 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

8820 Hospital Dr
Douglasville, GA 30134
Phone (678) 480-4034

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

55 Whitcher St NE
Ste 420
Marietta, GA 30060
Phone (770) 514-6760

Interoperability endpoints

  • Direct secure messaging: mwigley142090@directwellstar.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496275200000",
    "number": "1093243198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8820 HOSPITAL DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8820 HOSPITAL DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342266",
            "telephone_number": "770-947-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGLEY",
        "first_name": "MICHELLE",
        "middle_name": "D.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2017-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.