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Wellstar Physicians Group Hospitalists, LLC

Organization Active NPI Internal Medicine Physician · Marietta, GA

NPI 1629025754 · NPPES record last updated Jul 14, 2008

Key facts

NPI
1629025754
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
WELLSTAR PHYSICIANS GROUP 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
Organization subpart
Yes
Parent organization (as reported)
WELLSTAR HEALTH SYSTEM, INC.

Authorized official

Name
Nicole Ashe
Title
Executive Director of Finance
Phone
(770) 792-5261

Practitioners 64

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 64

National Provider Directory

Part of
NW Ga Nealth Systems in

Locations

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207R00000X Yes

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

  • WellStar Physicians Group Kennestone Hospitalists, LLC Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 14, 2008.

{
    "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

All providers in Marietta, GA · Internal Medicine Physician in Georgia

Sources for this page

Verify at the official NPI Registry.