Individual provider Active NPI

Anahita Mansouri, MD

  • Internal Medicine Physician
  • Marietta, GA
National Provider Identifier
1124768841
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
103988 Issued in GA
Practice address
355 Tower Rd NE Ste 300
Marietta, GA 30060-9408
Phone
(470) 956-2020
NPI assigned
Mar 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 103988 GA Primary

Addresses

Primary practice location

355 Tower Rd NE Ste 300
Marietta, GA 30060-9408

Mailing address

355 Tower Rd NE Ste 300
Marietta, GA 30060-9408

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
I20251008003264 GA Practitioner - Internal Medicine 4284014630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Georgia School of Medicine, 2022
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)

355 Tower Nerd
Marietta, GA 30060-9408

355 Tower Rd NE
Suite 300
Marietta, GA 30060-9408
Phone (770) 427-2457

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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2025 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2025 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

833 Campbell Hill St NW
Ste 250
Marietta, GA 30060
Phone (470) 956-2020

355 Tower Rd NE
Ste 300
Marietta, GA 30060
Phone (770) 426-4721

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 4

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": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1124768841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 TOWER RD NE STE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 TOWER RD NE STE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609408",
            "telephone_number": "470-956-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOURI",
        "first_name": "ANAHITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "103988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.