Individual provider Active NPI

Sydney Leigh Trevino, DO

  • Family Medicine Physician
  • Marietta, GA
National Provider Identifier
1649929191
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
103090 Issued in GA
Practice address
355 Tower Rd NE Ste 300
Marietta, GA 30060-9408
Phone
(770) 427-2457
Fax
(770) 427-2706
NPI assigned
Mar 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 103090 GA Primary

Addresses

Primary practice location

355 Tower Rd NE Ste 300
Marietta, GA 30060-9408

Mailing address

355 Tower Rd NE Ste 300
Marietta, GA 30060-9408
Phone (770) 427-2457

Other practice location 1

677 Church St NE
Marietta, GA 30060-1101
Phone (470) 956-4000

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
I20250827003314 GA Practitioner - Family Practice 2567841513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2022
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)

355 Tower Nerd
Marietta, GA 30060-9408

355 Tower Rd NE
Suite 300
Marietta, GA 30060-9408
Phone (770) 427-2457

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

Hospital & facility affiliations

  • Wellstar Home Health, LLC Home health agency, Marietta, GA, CCN 117102
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103090GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Aug 1, 2025 Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

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

355 Tower Rd NE
Ste 300
Marietta, GA 30060
Phone (770) 426-4721

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 5

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": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1649929191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 TOWER RD NE STE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609408",
            "telephone_number": "770-427-2457",
            "fax_number": "770-427-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 TOWER RD NE STE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609408",
            "telephone_number": "770-427-2457",
            "fax_number": "770-427-2706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "677 Church St NE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601101",
            "country_code": "US",
            "telephone_number": "470-956-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "SYDNEY",
        "middle_name": "LEIGH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "103090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.