Organization Active NPI

Wellstar West Cobb Medical Center, LLC

  • Family Medicine Physician
  • Marietta, GA
National Provider Identifier
1396791679
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WELLSTAR WEST COBB MEDICAL CENTER, LLC
Practice address
3707 Largent Way NW
Marietta, GA 30064-1672
Phone
(678) 581-5729
Fax
(678) 581-5719
NPI assigned
May 26, 2006
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X

Addresses

Primary practice location

3707 Largent Way NW
Marietta, GA 30064-1672

Mailing address

3707 Largent Way NW
Marietta, GA 30064-1672
Phone (678) 581-5729

National Provider Directory

National Provider Directory
Part of
NW Ga Nealth Systems in

Locations

3501 Baker Rd NW
Ste 100A
Acworth, GA 30101
Phone (470) 267-0620

1445 Harper St
Augusta, GA 30912
Phone (706) 721-4724

120 Greystone Power Blvd
Ste 110
Dallas, GA 30157
Phone (470) 267-1540

1120 15th St
Fort Gordon, GA 30905
Phone (678) 956-3861

1120 Wellstar Way
Ste 404
Holly Springs, GA 30114

11400 Tara Blvd
Lovejoy, GA 30228

4480 N Cooper Lake Rd SE
Smyrna, GA 30082
Phone (770) 333-2035

662 Carrollton Villa Rica Hwy
Ste 100
Villa Rica, GA 30180
Phone (943) 202-8590

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1396791679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 LARGENT WAY NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641672",
            "telephone_number": "678-581-5729",
            "fax_number": "678-581-5719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 LARGENT WAY NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641672",
            "telephone_number": "678-581-5729",
            "fax_number": "678-581-5719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR WEST COBB MEDICAL CENTER, 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": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 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.