NPIMap

Individual provider Active NPI

Bruce J Gould, MD

  • Hematology & Oncology Physician
  • Marietta, GA
National Provider Identifier
1326042706
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
032740 Issued in GA
Practice address
340 Kennestone Hospital Blvd Ste 100
Marietta, GA 30060-1158
Phone
(770) 281-5100
Fax
(678) 581-7100
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 032740 GA Primary

Addresses

Primary practice location

340 Kennestone Hospital Blvd Ste 100
Marietta, GA 30060-1158

Mailing address

531 Roselane St NW Ste 710
Marietta, GA 30060-6975
Phone (678) 331-3297

Other identifiers 7

IdentifierTypeStateIssuer
00416424CMedicaidGA
00416424FMedicaidGA
00416424AMedicaidGA
00416424BMedicaidGA
00416424DMedicaidGA
00416424EMedicaidGA
1326042706OtherGANPI NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031222000461 GA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 9436056322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1983
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)

1120 Wellstar Way
Holly Springs, GA 30114-9101
Phone (470) 610-0145

144 Bill Carruth Pkwy
Hiram, GA 30141-3819

1510 Vernon Rd
Lagrange, GA 30240-4131
Phone (706) 845-3905

1514 Vernon Rd
Lagrange, GA 30240-4131
Phone (706) 880-7222

1605 Mulkey Rd
Suite B
Austell, GA 30106-6820
Phone (470) 956-3760

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2912

4441 Atlanta Rd SE
Smyrna, GA 30080-6443

4500 Hospital Blvd
Roswell, GA 30076-0001

5 Cloverleaf Dr
Cartersville, GA 30120-2177
Phone (770) 386-7253

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

619 S 8TH St
Griffin, GA 30224-4260

Hospital & facility affiliations

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince May 1, 2019 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

1700 Hospital South Dr
Ste 300
Austell, GA 30106
Phone (770) 944-2830

144 Bill Carruth Pkwy
Ste 3100
Hiram, GA 30141
Phone (678) 363-1940

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

340 Kennestone Hospital Blvd
Ste 100
Marietta, GA 30060
Phone (770) 281-5100

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

Interoperability endpoints

  • Direct secure messaging: bgould61943@directwellstar.org

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 16

Hospital & facility affiliations 4

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1326042706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 ROSELANE ST NW STE 710",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300606975",
            "telephone_number": "678-331-3297",
            "fax_number": "678-581-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 KENNESTONE HOSPITAL BLVD STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601158",
            "telephone_number": "770-281-5100",
            "fax_number": "678-581-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "BRUCE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "032740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00416424C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00416424F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00416424A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00416424B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00416424D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00416424E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1326042706",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.