NPIMap

Individual provider Active NPI

David Gose, MD

  • Internal Medicine Physician
  • Hiram, GA
National Provider Identifier
1528040748
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
049694 Issued in GA
Practice address
176 Charles Hardy Pkwy Unit C
Hiram, GA 30141-1836
Phone
(678) 945-8200
Fax
(678) 945-8209
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 049694 GA Primary

Addresses

Primary practice location

176 Charles Hardy Pkwy Unit C
Hiram, GA 30141-1836

Mailing address

176 Charles Hardy Pkwy Unit C
Hiram, GA 30141-1836
Phone (678) 945-8200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dgose13656@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
I20080520000545 GA Practitioner - Internal Medicine 5294804001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Georgia School of Medicine, 1999
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)

176 Charles Hardy Pkwy C
Hiram, GA 30141-1836
Phone (678) 945-8200

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

Hospital & facility affiliations

  • Central Home Health Care, an Amedisys Company Home health agency, Douglasville, GA, CCN 117050
  • Wellstar Home Health, LLC Home health agency, Marietta, GA, CCN 117102
  • Accentcare Home Health of Georgia Home health agency, Roswell, GA, CCN 117131
  • Central HH Care, an Amedisys Company Home health agency, Atlanta, GA, CCN 117039
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184
  • 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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Mar 1, 2011 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Mar 1, 2011 Accepting new patients
Wellstar East Paulding Primary Care Center, LLC Internal Medicine Current Accepting new patients

Locations

176 Charles Hardy Pkwy
#C
Hiram, GA 30141
Phone (678) 945-8200

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

Interoperability endpoints

  • Direct secure messaging: dgose13656@directwellstar.org

Organizations & group practices 4

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1528040748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 CHARLES HARDY PKWY UNIT C",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301411836",
            "telephone_number": "678-945-8200",
            "fax_number": "678-945-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 CHARLES HARDY PKWY UNIT C",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301411836",
            "telephone_number": "678-945-8200",
            "fax_number": "678-945-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSE",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "049694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgose13656@directwellstar.org",
            "affiliation": "N",
            "address_1": "176 Charles Hardy Pkwy Unit C",
            "city": "Hiram",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301411836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

Verify at the official NPI Registry.