NPIMap

Organization Active NPI

Wellstar Medical Group, LLC

Doing business as WellStar Urgent Care at Cooper Lake

  • Urgent Care Clinic/Center
  • Smyrna, GA
National Provider Identifier
1669767364
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Doing business as
WellStar Urgent Care at Cooper Lake
Practice address
4480 N Cooper Lake Rd SE
Suite 100
Smyrna, GA 30082-4622
Phone
(770) 333-1300
Fax
(770) 432-8312
NPI assigned
Jun 10, 2011
Last updated
Jun 10, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
WELLSTAR MEDICAL GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X GA Primary

Addresses

Primary practice location

4480 N Cooper Lake Rd SE
Suite 100
Smyrna, GA 30082-4622

Mailing address

4480 N Cooper Lake Rd SE
Suite 100
Smyrna, GA 30082-4622
Phone (770) 333-1300

Other names 1

  • WellStar Urgent Care at Cooper Lake Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pulmonary Wellstar125 organizations share this tax ID, including this one
Part of
Pulmonary Wellstar

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

4480 N Cooper Lake Rd SE
Ste 100
Smyrna, GA 30082
Phone (770) 331-1300

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307664000000",
    "number": "1669767364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4480 N COOPER LAKE RD SE",
            "address_2": "SUITE 100",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300824622",
            "telephone_number": "770-333-1300",
            "fax_number": "770-432-8312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4480 N COOPER LAKE RD SE",
            "address_2": "SUITE 100",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300824622",
            "telephone_number": "770-333-1300",
            "fax_number": "770-432-8312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLSTAR MEDICAL GROUP, LLC",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-06-10",
        "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",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellStar Urgent Care at Cooper Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; 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.