NPIMap

Individual provider Active NPI

Jie Liu, M.D PH.D

  • Internal Medicine Physician
  • Marietta, GA
National Provider Identifier
1396972402
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
77067 Issued in GA
Practice address
355 Tower Rd NE Ste 300
Marietta, GA 30060-9408
Phone
(770) 427-2457
Fax
(770) 427-2706
NPI assigned
Jun 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 52033 CT
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 77067 GA Primary

Addresses

Primary practice location

355 Tower Rd NE Ste 300
Marietta, GA 30060-9408

Mailing address

355 Tower Rd NE Ste 300
Marietta, GA 30060-9408

Other identifiers 1

IdentifierTypeStateIssuer
004236346MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jliu131932@directwellstar.org

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
I20161214001859 GA Practitioner - Internal Medicine 9931338787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

355 Tower Nerd
Marietta, GA 30060-9408

355 Tower Rd NE
Suite 300
Marietta, GA 30060-9408
Phone (770) 427-2457

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

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

Hospital & facility affiliations

  • Wellstar Home Health, LLC Home health agency, Marietta, GA, CCN 117102
  • Central HH Care, an Amedisys Company Home health agency, Atlanta, GA, CCN 117039
  • Community Home Health, an Amedisys Company Home health agency, Woodstock, GA, CCN 117130
  • Accentcare Home Health of Georgia Home health agency, Roswell, GA, CCN 117131
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

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, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
77067GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Dec 12, 2016 Accepting new patients
Wellstar Medical Group, LLC Internal Medicine CurrentSince Dec 12, 2016 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

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

355 Tower Rd NE
Ste 300
Marietta, GA 30060
Phone (770) 426-4721

Organizations & group practices 3

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

Hospital & facility affiliations 9

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": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1396972402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 TOWER RD NE STE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 TOWER RD NE STE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609408",
            "telephone_number": "770-427-2457",
            "fax_number": "770-427-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "JIE",
        "name_prefix": "Dr.",
        "credential": "M.D PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "52033",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "77067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236346",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jliu131932@directwellstar.org",
            "affiliation": "N",
            "address_1": "355 Tower Rd NE Ste 300",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300609408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.