Organization Active NPI

Wellstar Occupational Health, LLC

  • Internal Medicine Physician
  • Austell, GA
National Provider Identifier
1336195445
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WELLSTAR OCCUPATIONAL HEALTH, LLC
Practice address
1680 Hospital South Dr
Austell, GA 30106-8110
Phone
(770) 732-3880
Fax
(770) 732-2229
NPI assigned
May 26, 2006
Last updated
Jul 14, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
WELLSTAR HEALTH SYSTEM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1680 Hospital South Dr
Austell, GA 30106-8110

Mailing address

1680 Hospital South Dr
Austell, GA 30106-8110
Phone (770) 732-3880

National Provider Directory

National Provider Directory
Part of
NW Ga Health System Inc

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1336195445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 HOSPITAL SOUTH DR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068110",
            "telephone_number": "770-732-3880",
            "fax_number": "770-732-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 HOSPITAL SOUTH DR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068110",
            "telephone_number": "770-732-3880",
            "fax_number": "770-732-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR OCCUPATIONAL HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLSTAR HEALTH SYSTEM, INC.",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-07-14",
        "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": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "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 Jul 14, 2008; 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.