NPIMap

Individual provider Active NPI

William David Green, MD

  • Obstetrics & Gynecology Physician
  • Austell, GA
National Provider Identifier
1689646598
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
042584 Issued in GA
Practice address
1791 Mulkey Rd
Suite 200
Austell, GA 30106-1124
Phone
(770) 732-5400
Fax
(770) 944-0327
NPI assigned
Feb 3, 2006
Last updated
Sep 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 042584 GA Primary

Addresses

Primary practice location

1791 Mulkey Rd
Suite 200
Austell, GA 30106-1124

Mailing address

1791 Mulkey Rd
Suite 200
Austell, GA 30106-1124
Phone (770) 732-5400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wgreen7917@directwellstar.org

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

LicenseStateTypeSpecialty
042584GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Obstetrics & Gynecology Past Accepting new patients
Wellstar Health System, Inc. Past Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1689646598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 MULKEY RD",
            "address_2": "SUITE 200",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061124",
            "telephone_number": "770-732-5400",
            "fax_number": "770-944-0327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1791 MULKEY RD",
            "address_2": "SUITE 200",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061124",
            "telephone_number": "770-732-5400",
            "fax_number": "770-944-0327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "042584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wgreen7917@directwellstar.org",
            "affiliation": "N",
            "address_1": "1791 Mulkey Rd",
            "address_2": "Suite 200",
            "city": "Austell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301061124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.