Individual provider Active NPI

Theolyn N Price, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Roswell, GA
National Provider Identifier
1265402317
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
80819 Issued in GA
Practice address
2500 Hospital Blvd Ste 420
Roswell, GA 30076
Phone
(704) 249-7327
Fax
(770) 421-0228
NPI assigned
Jan 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 45827 MN
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X ME110622 FL
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 52769 CO
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 80819 GA Primary

Addresses

Primary practice location

2500 Hospital Blvd Ste 420
Roswell, GA 30076

Mailing address

2500 Hospital Blvd Ste 420
Roswell, GA 30076-4919
Phone (704) 249-7327

Other practice location 1

2222 N Nevada Ave
Suite 5011
Colorado Springs, CO 80907-6819
Phone (719) 776-7600

Other practice location 2

2222 N Nevada Ave
Suite 5011
Colorado Springs, CO 80907-6819
Phone (719) 776-7600

Other identifiers 4

IdentifierTypeStateIssuer
003983700MedicaidMN
P00042740OtherMNRAILROAD MEDICARE
ENROLLEDMedicaidIA
35294500MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tprice173447@directwellstar.org

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
I20181204004016 GA Practitioner - Thoracic Surgery 5799851291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Alabama School of Medicine, 2002
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)

2500 Hospital Blvd
Suite 420
Roswell, GA 30076-4919
Phone (770) 410-4366

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Wellstar Spalding Medical Center Hospital, Griffin, GA, CCN 110031
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52769COMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
80819GAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Aug 7, 2018 Accepting new patients

Locations

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

61 Whitcher St NE
Ste 4120
Marietta, GA 30060

2500 Hospital Blvd
Ste 420
Roswell, GA 30076
Phone (770) 410-4366

4500 Hospital Blvd
Ste 230
Roswell, GA 30076
Phone (470) 956-4560

Organizations & group practices 2

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 6

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1265402317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD STE 420",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764919",
            "telephone_number": "704-249-7327",
            "fax_number": "770-421-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD STE 420",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "704-249-7327",
            "fax_number": "770-421-0228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 N Nevada Ave",
            "address_2": "SUITE 5011",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809076819",
            "country_code": "US",
            "telephone_number": "719-776-7600",
            "fax_number": "719-473-3553",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 N Nevada Ave",
            "address_2": "SUITE 5011",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809076819",
            "country_code": "US",
            "telephone_number": "719-776-7600",
            "fax_number": "719-473-3553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRICE",
        "first_name": "THEOLYN",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "45827",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME110622",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CO",
            "license": "52769",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "GA",
            "license": "80819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003983700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00042740",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35294500",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tprice173447@directwellstar.org",
            "affiliation": "N",
            "address_1": "2500 Hospital Blvd Ste 420",
            "city": "Roswell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300764919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.