Dominique Michelle Grasty Hines, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

95066 Issued in GA

Practice address

4581 S Cobb Dr SE Ste 100
Smyrna, GA 30080-6906

Phone

(770) 801-5000

Fax

(770) 435-6690

NPI assigned

Apr 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD

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

{
    "created_epoch": "1585958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1518596246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4581 S COBB DR SE STE 100",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806906",
            "telephone_number": "770-801-5000",
            "fax_number": "770-435-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4581 S COBB DR SE STE 100",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806906",
            "telephone_number": "770-801-5000",
            "fax_number": "770-435-6690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Westview Dr SW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303101458",
            "country_code": "US",
            "telephone_number": "404-756-1393",
            "fax_number": "404-756-1357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINES",
        "first_name": "DOMINIQUE",
        "middle_name": "MICHELLE GRASTY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-04",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "95066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dhines526952@directwellstar.org",
            "affiliation": "N",
            "address_1": "4581 S Cobb Dr SE Ste 100",
            "city": "Smyrna",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300806906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jayme Renee' Higgins, ATC
• Highland Rivers Behavior Health
• Highlands Anesthesia Associates LLC
• Jared Hill
• Krysten Kelly Hill, DPT
• Randy Hines II, M.D.
• Hintons Integrative Medicine Him LLC
• Erin Hintt
• HJ Health Agency, LLC
• Kevin Hoang

• Pediatrics Physician in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.