Individual provider Active NPI

Matthew Lee Estes, NP-C

  • Nurse Practitioner
  • Hiram, GA
National Provider Identifier
1104213339
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN184263 Issued in GA
Practice address
148 Bill Carruth Pkwy Ste 220
Hiram, GA 30141
Phone
(770) 505-0023
Fax
(770) 505-9003
NPI assigned
Apr 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN184263 GA
Nurse Practitioner 363L00000X RN184263 GA Primary

Addresses

Primary practice location

148 Bill Carruth Pkwy Ste 220
Hiram, GA 30141

Mailing address

148 Bill Carruth Pkwy Ste 220
Hiram, GA 30141-3756
Phone (770) 505-0023

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150608002073 GA Practitioner - Nurse Practitioner 1658692231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
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)

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 Hospital, Hiram, GA, CCN 110042

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN184263GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince May 10, 2015 Accepting new patients
Wellstar Medical Group, LLC CurrentSince May 10, 2015 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

4550 Cobb Parkway North NW
Ste 305
Acworth, GA 30101
Phone (770) 792-5275

148 Bill Carruth Pkwy
Ste 220
Hiram, GA 30141
Phone (770) 505-0023

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

699 Church St NE
Ste 340
Marietta, GA 30060
Phone (678) 355-1620

Interoperability endpoints

  • Direct secure messaging: mestes16580@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.

Hospital & facility affiliations 1

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": "1430006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1104213339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 BILL CARRUTH PKWY STE 220",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301413756",
            "telephone_number": "770-505-0023",
            "fax_number": "770-505-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 BILL CARRUTH PKWY STE 220",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "30141",
            "telephone_number": "770-505-0023",
            "fax_number": "770-505-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTES",
        "first_name": "MATTHEW",
        "middle_name": "LEE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-26",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN184263",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN184263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

Verify at the official NPI Registry.