NPIMap

Wellstar Medical Group, LLC

Organization Active NPI Transplant Surgery Physician · Marietta, GA

NPI 1215330451 · NPPES record last updated Oct 2, 2014

Key facts

NPI
1215330451
Entity type
Organization (NPI type 2)
Primary specialty
Transplant Surgery Physician 204F00000X
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Practice address
793 Sawyer Rd
Marietta, GA 30062-2222
Phone
(470) 644-0170
Fax
(770) 563-0741
NPI assigned
Oct 2, 2014
Organization subpart
Yes
Parent organization (as reported)
WELLSTAR MEDICAL GROUP, LLC

Authorized official

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

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Wellstar Medical Group LLC (125 organizations share this tax ID)
Part of
Wellstar Medical Group LLC

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 204F00000X GA Yes

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

  • WellStar Transplant Surgery Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 2, 2014.

{
    "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

All providers in Marietta, GA · Transplant Surgery Physician in Georgia

Sources for this page

Verify at the official NPI Registry.