NPIMap

Organization Active NPI

Wellstar Paulding Surgical Associates, LLC

  • Surgery Physician
  • Hiram, GA
National Provider Identifier
1104871201
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
WELLSTAR PAULDING SURGICAL ASSOCIATES, LLC
Practice address
176 Marietta Hwy
Building a
Hiram, GA 30141-1836
Phone
(770) 445-4915
Fax
(770) 445-6876
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Nicole Ashe
Title
Executive Director of Finance
Phone
(770) 792-5261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

176 Marietta Hwy
Building a
Hiram, GA 30141-1836

Mailing address

176 Marietta Hwy
Building a
Hiram, GA 30141-1836
Phone (770) 445-4915

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104871201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 MARIETTA HWY",
            "address_2": "BUILDING A",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301411836",
            "telephone_number": "770-445-4915",
            "fax_number": "770-445-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 MARIETTA HWY",
            "address_2": "BUILDING A",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301411836",
            "telephone_number": "770-445-4915",
            "fax_number": "770-445-6876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR PAULDING SURGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ASHE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "770-792-5261"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.