Individual provider Active NPI

Torey Scott Harden, M.D.

  • Pediatrics Physician
  • Lagrange, GA
National Provider Identifier
1275827396
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
71831 Issued in GA
Practice address
301 Medical Dr
Ste 504
Lagrange, GA 30240-4144
Phone
(706) 812-2655
Fax
(706) 812-2428
NPI assigned
Jun 6, 2011
Sex
Male
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 71831 GA Primary

Addresses

Primary practice location

301 Medical Dr
Ste 504
Lagrange, GA 30240-4144

Mailing address

301 Medical Dr
Ste 504
Lagrange, GA 30240-4144
Phone (706) 812-2655

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tharden134994@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
I20141003001747 GA Practitioner - Pediatric Medicine 0749400216 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71831GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince May 7, 2017 Accepting new patients
Cosmic Pediatrics LLC Pediatrics Current Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

454 Lagrange St
Greenville, GA 30222
Phone (706) 672-4251

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

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

301 Medical Dr
Ste 504
Lagrange, GA 30240
Phone (706) 812-2655

1514 Vernon Rd
Lagrange, GA 30240
Phone (706) 812-2369

61 Robinson Lake Rd
Newnan, GA 30265
Phone (678) 633-3260

Interoperability endpoints

  • Direct secure messaging: tharden134994@directwellstar.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1275827396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MEDICAL DR",
            "address_2": "STE 504",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404144",
            "telephone_number": "706-812-2655",
            "fax_number": "706-812-2428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MEDICAL DR",
            "address_2": "STE 504",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404144",
            "telephone_number": "706-812-2655",
            "fax_number": "706-812-2428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEN",
        "first_name": "TOREY",
        "middle_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-06",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "71831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tharden134994@directwellstar.org",
            "affiliation": "N",
            "address_1": "301 Medical Dr",
            "address_2": "Ste 504",
            "city": "LaGrange",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302404144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.