Organization Active NPI

Wellstar

  • Audiologist
  • Marietta, GA
National Provider Identifier
1275834616
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD003861 Issued in GA
Legal business name
WELLSTAR
Practice address
320 Kennestone Hospital Blvd
Suite 107
Marietta, GA 30060-1161
Phone
(770) 793-7417
NPI assigned
Nov 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Authorized official

Name
Rebecca Ann Ratliff, AU.D.
Title
Audiologist
Phone
(770) 793-7414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X AUD003861 GA Primary

Addresses

Primary practice location

320 Kennestone Hospital Blvd
Suite 107
Marietta, GA 30060-1161

Mailing address

320 Kennestone Hospital Blvd
Suite 107
Marietta, GA 30060-1161
Phone (770) 793-7417

Other names 1

  • ENT Associates of North Georgia Other name

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://epicsoap.wellstar.org/fhirproxy/api/FHIR/R4/

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1275834616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 KENNESTONE HOSPITAL BLVD",
            "address_2": "SUITE 107",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601161",
            "telephone_number": "770-793-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 KENNESTONE HOSPITAL BLVD",
            "address_2": "SUITE 107",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601161",
            "telephone_number": "770-793-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "RATLIFF",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "AUDIOLOGIST",
        "authorized_official_telephone_number": "770-793-7414",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "GA",
            "license": "AUD003861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ENT Associates of North Georgia",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 16, 2010; 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.