Individual provider Active NPI

Renee T Page, MD

  • Gynecology Physician
  • Augusta, GA
National Provider Identifier
1275573156
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
073769 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912-0004
Phone
(706) 724-6100
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 4301074728 MI
Gynecology Physician 207VG0400X 073769 GA Primary

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912-0004

Mailing address

1499 Walton Way
Suite 1400
Augusta, GA 30901-2602

Other practice location 1

833 Campbell Hill St NW Ste 420
Marietta, GA 30060-1138
Phone (770) 528-0260

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rpage531258@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060707000254 MI Practitioner - Obstetrics/Gynecology 4981616158 Reassigns benefits to 1 organization
I20150714000848 GA Practitioner - Obstetrics/Gynecology 4981616158 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Emory University School of Medicine, 1999
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)

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

833 Campbell Hill St NW
Suite 420
Marietta, GA 30060-1138
Phone (470) 956-3860

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
073769GAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Oct 15, 2023 Accepting new patients
Iha Health Service Corporation CurrentSince Jan 1, 2015 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Augusta University CurrentSince Sep 1, 2020 Accepting new patients
Au Medical Center, Inc Current Accepting new patients
Au Medical Associates Inc CurrentSince Jun 1, 2015 Accepting new patients
Iha Health Services Corporation CurrentSince Jan 1, 2015 Accepting new patients
Au Medical Associates Inc CurrentSince Jun 1, 2015 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Kennestone Hospital, Inc. Past Accepting new patients
University Women'S Care, Inc Past Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

997 Saint Sebastian Way
Augusta, GA 30912
Phone (706) 721-3141

1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

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

833 Campbell Hill St NW
Ste 420
Marietta, GA 30060
Phone (470) 956-3860

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5325 Elliott Dr
Ste 203
Ypsilanti, MI 48197
Phone (734) 712-8020

Organizations & group practices 12

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 1

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1275573156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 WALTON WAY",
            "address_2": "SUITE 1400",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-724-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 Campbell Hill St NW Ste 420",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601138",
            "country_code": "US",
            "telephone_number": "770-528-0260",
            "fax_number": "770-582-0269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAGE",
        "first_name": "RENEE",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MI",
            "license": "4301074728",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "GA",
            "license": "073769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpage531258@directwellstar.org",
            "affiliation": "N",
            "address_1": "833 Campbell Hill St NW Ste 420",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.