Organization Active NPI

Wellstar Powder Springs Medical Center, LLC

  • Family Medicine Physician
  • Powder Springs, GA
National Provider Identifier
1184671273
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WELLSTAR POWDER SPRINGS MEDICAL CENTER, LLC
Practice address
4250 Brownsville Rd
Powder Springs, GA 30127-2559
Phone
(678) 567-8000
Fax
(770) 439-3555
NPI assigned
May 27, 2006
Organization subpart
Yes
Parent organization
WELLSTAR HEALTH SYSTEM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4250 Brownsville Rd
Powder Springs, GA 30127-2559

Mailing address

4250 Brownsville Rd
Powder Springs, GA 30127-2559
Phone (678) 567-8000

National Provider Directory

National Provider Directory
Part of
NW Ga Nealth Systems in

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1184671273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 BROWNSVILLE RD",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301272559",
            "telephone_number": "678-567-8000",
            "fax_number": "770-439-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 BROWNSVILLE RD",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301272559",
            "telephone_number": "678-567-8000",
            "fax_number": "770-439-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR POWDER SPRINGS MEDICAL CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLSTAR HEALTH SYSTEM, INC.",
        "enumeration_date": "2006-05-27",
        "last_updated": "2008-07-14",
        "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": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powder Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.