NPIMap

Organization Active NPI

Wellstar Cobb Surgical Associates, LLC

  • Surgery Physician
  • Austell, GA
National Provider Identifier
1285689844
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
WELLSTAR COBB SURGICAL ASSOCIATES, LLC
Practice address
1810 Mulkey Rd
Suite 105
Austell, GA 30106-1151
Phone
(770) 944-0686
Fax
(770) 948-9341
NPI assigned
May 23, 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
Nicole Ashe
Title
Executive Director of Finance
Phone
(770) 792-5261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1810 Mulkey Rd
Suite 105
Austell, GA 30106-1151

Mailing address

1810 Mulkey Rd
Suite 105
Austell, GA 30106-1151
Phone (770) 944-0686

National Provider Directory

National Provider Directory

Locations

1700 Hospital South Dr
Ste 303
Austell, GA 30106

1810 Mulkey Rd
Austell, GA 30106
Phone (678) 540-7597

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285689844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 MULKEY RD",
            "address_2": "SUITE 105",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061151",
            "telephone_number": "770-944-0686",
            "fax_number": "770-948-9341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 MULKEY RD",
            "address_2": "SUITE 105",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061151",
            "telephone_number": "770-944-0686",
            "fax_number": "770-948-9341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR COBB SURGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ASHE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "770-792-5261"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, 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.