NPIMap

Organization Active NPI

Wellstar Cherokee Street Internal and Preventive Medicine, LLC

  • Internal Medicine Physician
  • Marietta, GA
National Provider Identifier
1235183948
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WELLSTAR CHEROKEE STREET INTERNAL AND PREVENTIVE MEDICINE, LLC
Practice address
191 Cherokee St NE
Marietta, GA 30060-1609
Phone
(678) 354-3426
Fax
(678) 354-3469
NPI assigned
May 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Nicole V Ashe
Title
Executive Director of Finance
Phone
(770) 792-5261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

191 Cherokee St NE
Marietta, GA 30060-1609

Mailing address

191 Cherokee St NE
Marietta, GA 30060-1609
Phone (678) 354-3426

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235183948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 CHEROKEE ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601609",
            "telephone_number": "678-354-3426",
            "fax_number": "678-354-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 CHEROKEE ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601609",
            "telephone_number": "678-354-3426",
            "fax_number": "678-354-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR CHEROKEE STREET INTERNAL AND PREVENTIVE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ASHE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "770-792-5261",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.