Active NPI
Wellstar Internal Medicine of Cobb, LLC
- Internal Medicine Physician
- Austell, GA
National Provider Identifier
1528014107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- WELLSTAR INTERNAL MEDICINE OF COBB, LLC
- Practice address
- 1790 Mulkey Rd
Suite 10
Austell, GA 30106-1122 - Phone
- (770) 739-6071
- Fax
- (770) 739-4632
- NPI assigned
- May 26, 2006
- Organization subpart
- Yes
- Parent organization
- WELLSTAR HEALTH SYSTEM, INC.
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
1790 Mulkey Rd
Suite 10
Austell, GA 30106-1122
Mailing address
1790 Mulkey Rd
Suite 10
Austell, GA 30106-1122
Phone (770) 739-6071
National Provider Directory
National Provider Directory- Part of
- NW Ga Nealth Systems in
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": "1528014107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1790 MULKEY RD",
"address_2": "SUITE 10",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301061122",
"telephone_number": "770-739-6071",
"fax_number": "770-739-4632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1790 MULKEY RD",
"address_2": "SUITE 10",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301061122",
"telephone_number": "770-739-6071",
"fax_number": "770-739-4632"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLSTAR INTERNAL MEDICINE OF COBB, 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
- Wellstar Cobb Rehabilitation Medicine, LLC
- Wellstar Cobb Surgical Associates, LLC
- Wellstar Community Hospice, LLC
- Wellstar Health System
- Wellstar Health Systems
- Wellstar Medical Group, LLC
- Wellstar Medical Group, LLC
- Wellstar Medical Group, LLC
- Wellstar Medical Group, LLC
- Wellstar Medical Group, LLC
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.