NPIMap

Organization Active NPI

Wellstar Medical Group, LLC

Doing business as WellStar Transplant Surgery

  • Transplant Surgery Physician
  • Marietta, GA
National Provider Identifier
1215330451
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transplant Surgery PhysicianTaxonomy code 204F00000X
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Doing business as
WellStar Transplant Surgery
Practice address
793 Sawyer Rd
Marietta, GA 30062-2222
Phone
(470) 644-0170
Fax
(770) 563-0741
NPI assigned
Oct 2, 2014
Last updated
Oct 2, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
WELLSTAR MEDICAL GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

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

Authorized official

Name
Mrs. Nicole Ashe
Title
Executive Director of Finance
Phone
(470) 644-0095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 204F00000X GA Primary

Addresses

Primary practice location

793 Sawyer Rd
Marietta, GA 30062-2222

Mailing address

793 Sawyer Rd
Marietta, GA 30062-2222
Phone (470) 644-0170

Other names 1

  • WellStar Transplant Surgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wellstar Medical Group East Paulding Pediatrics126 organizations share this tax ID, including this one
Part of
Wellstar Medical Group East Paulding Pediatrics

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1215330451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 SAWYER RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300622222",
            "telephone_number": "470-644-0170",
            "fax_number": "770-563-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 SAWYER RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300622222",
            "telephone_number": "470-644-0170",
            "fax_number": "770-563-0741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLSTAR MEDICAL GROUP, LLC",
        "enumeration_date": "2014-10-02",
        "last_updated": "2014-10-02",
        "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": "470-644-0095",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Transplant Surgery",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellStar Transplant Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.