Individual provider Active NPI

Joan H. Zeller, MD

  • Obstetrics & Gynecology Physician
  • Carrollton, GA
National Provider Identifier
1538247556
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
47043 Issued in GA
Practice address
109 Professional PL
Carrollton, GA 30117-3862
Phone
(770) 834-0170
Fax
(770) 214-1546
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 47043 GA Primary

Addresses

Primary practice location

109 Professional PL
Carrollton, GA 30117-3862

Mailing address

119 Ambulance Dr 202
Carrollton, GA 30117-3857
Phone (770) 838-8710

Other identifiers 5

IdentifierTypeStateIssuer
581456616OtherGATAX ID
333750OtherGAWELLCARE
52728648001OtherGABLUE CROSS BLUE SHIELD
000824051AOtherGAPEACH STATE
00824051AMedicaidGA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070509000446 GA Practitioner - Obstetrics/Gynecology 7911003868 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

706 Dixie St
Suite 200
Carrollton, GA 30117-3819
Phone (770) 214-2121

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47043GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Georgia Obstetrics & Gynecology P.C. Obstetrics & Gynecology CurrentSince Jul 1, 1999 Accepting new patients
Tanner Medical Group Inc Obstetrics & Gynecology CurrentSince Jan 4, 2016 Accepting new patients
TMC Children's Healthcare of West Georgia Past Accepting new patients

Locations

119 Ambulance Dr
Ste 202
Carrollton, GA 30117
Phone (770) 838-8710

157 Clinic Ave
Ste 302A
Carrollton, GA 30117
Phone (770) 812-5886

109 Professional Pl
Carrollton, GA 30117
Phone (770) 834-0170

706 Dixie St
Ste 200
Carrollton, GA 30117
Phone (770) 214-2121

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

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 3

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1538247556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-838-8710",
            "fax_number": "770-838-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PROFESSIONAL PL",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173862",
            "telephone_number": "770-834-0170",
            "fax_number": "770-214-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELLER",
        "first_name": "JOAN",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "47043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "581456616",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "333750",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "52728648001",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACH STATE",
            "identifier": "000824051A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00824051A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.