NPIMap

Organization Active NPI

Wellstar Physicians Group Hospitalists, LLC

Doing business as WellStar Physicians Group Kennestone Hospitalists, LLC

  • Internal Medicine Physician
  • Marietta, GA
National Provider Identifier
1629025754
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WELLSTAR PHYSICIANS GROUP HOSPITALISTS, LLC
Doing business as
WellStar Physicians Group Kennestone Hospitalists, LLC
Practice address
677 Church St NE
Box 111
Marietta, GA 30060-1101
Phone
(770) 793-7750
Fax
(770) 792-7755
NPI assigned
May 26, 2006
Last updated
Jul 14, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
WELLSTAR HEALTH SYSTEM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

677 Church St NE
Box 111
Marietta, GA 30060-1101

Mailing address

677 Church St NE
Box 111
Marietta, GA 30060-1101
Phone (770) 793-7750

Other names 1

  • WellStar Physicians Group Kennestone Hospitalists, LLC Doing business as

National Provider Directory

National Provider Directory
Part of
NW Ga Health System Inc

Locations

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

Practitioners & affiliated clinicians

Practitioners 64

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 64

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": "1629025754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 CHURCH ST NE",
            "address_2": "BOX 111",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601101",
            "telephone_number": "770-793-7750",
            "fax_number": "770-792-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 CHURCH ST NE",
            "address_2": "BOX 111",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601101",
            "telephone_number": "770-793-7750",
            "fax_number": "770-792-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR PHYSICIANS GROUP HOSPITALISTS, 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": [
        {
            "organization_name": "WellStar Physicians Group Kennestone Hospitalists, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

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.

Verify at the official NPI Registry.