Active NPI
Melanie Susannah Wooten, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Athens, GA
National Provider Identifier
1629464912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 79582
- Practice address
- 1199 Prince Ave
Athens, GA 30606-2797 - Phone
- (706) 475-7000
- NPI assigned
- Apr 13, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 79582 | GA | Primary |
| Clinical Pathology Physician | 207ZC0006X | 79582 | GA |
Addresses
Primary practice location
1199 Prince Ave
Athens, GA 30606-2797
Mailing address
5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325
Other practice location 1
1120 15th St
Augusta, GA 30912-1059
Phone (706) 721-8623
Other practice location 2
1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 727-5658
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79582 | GA | MD | Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783468800000",
"number": "1629464912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5700 SOUTHWYCK BLVD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436141509",
"telephone_number": "800-288-8325",
"fax_number": "419-866-5453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1199 PRINCE AVE",
"city": "ATHENS",
"state": "GA",
"postal_code": "306062797",
"telephone_number": "706-475-7000"
}
],
"practiceLocations": [
{
"address_1": "1120 15th St",
"address_purpose": "LOCATION",
"city": "Augusta",
"state": "GA",
"postal_code": "309121059",
"country_code": "US",
"telephone_number": "706-721-8623",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1364 Clifton Rd NE",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303221059",
"country_code": "US",
"telephone_number": "404-727-5658",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOOTEN",
"first_name": "MELANIE",
"middle_name": "SUSANNAH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-13",
"last_updated": "2026-07-08",
"certification_date": "2026-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "GA",
"license": "79582",
"primary": true
},
{
"code": "207ZC0006X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology",
"state": "GA",
"license": "79582",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.