Individual provider Active NPI

Gabriella Eliese Maris, MD

  • Family Medicine Physician
  • Morrow, GA
National Provider Identifier
1114212552
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
073819 Issued in GA
Practice address
1000 Corporate Center Dr
Suite 200
Morrow, GA 30260-4180
Phone
(770) 968-6464
Fax
(770) 968-6455
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD451019 PA
Family Medicine Physician 207Q00000X 073819 GA Primary

Addresses

Primary practice location

1000 Corporate Center Dr
Suite 200
Morrow, GA 30260-4180

Mailing address

1000 Corporate Center Dr
Suite 200
Morrow, GA 30260-4180
Phone (770) 968-6464

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gmaris123333@directwellstar.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160201002191 GA Practitioner - Family Practice 6507080397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 2011
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)

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

6002 Professional Pkwy
Douglasville, GA 30134-5627

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (678) 838-2585

Hospital & facility affiliations

  • Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
073819GAMDFamily Medicine Physician
MD451019PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2016 Accepting new patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2016 Accepting new patients
Douglas Hospital, Inc. Past Accepting new patients

Locations

560 Amsterdam Ave NE
Ste D
Atlanta, GA 30306
Phone (404) 479-5708

303 Parkway Dr NE
Atlanta, GA 30312
Phone (404) 265-4000

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

1000 Corporate Center Dr
Ste 200
Morrow, GA 30260
Phone (770) 968-6464

Interoperability endpoints

  • Direct secure messaging: gmaris123333@directwellstar.org
  • Direct secure messaging: gabriella.maris.p52@direct.tenet.nextgenshare.com

Organizations & group practices 4

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 2

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": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1114212552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CORPORATE CENTER DR",
            "address_2": "SUITE 200",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302604180",
            "telephone_number": "770-968-6464",
            "fax_number": "770-968-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CORPORATE CENTER DR",
            "address_2": "SUITE 200",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302604180",
            "telephone_number": "770-968-6464",
            "fax_number": "770-968-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIS",
        "first_name": "GABRIELLA",
        "middle_name": "ELIESE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD451019",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "073819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmaris123333@directwellstar.org",
            "affiliation": "N",
            "address_1": "1000 Corporate Center Dr",
            "address_2": "Suite 200",
            "city": "Morrow",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302604180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Morrow, GA

Sources for this page

Verify at the official NPI Registry.