Individual provider Active NPI

Joanna Dolgoff, M.D.

  • Pediatrics Physician
  • Hiram, GA
National Provider Identifier
1720065436
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
222857 Issued in NY
Practice address
51 Hiram Dr BLDG B
Hiram, GA 30141
Phone
(678) 945-8300
Fax
(770) 445-2060
NPI assigned
Dec 23, 2005
Last updated
Oct 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 222857 NY Primary
Pediatrics Physician 208000000X 80968 GA

Addresses

Primary practice location

51 Hiram Dr BLDG B
Hiram, GA 30141

Mailing address

805 Sandy Plains Road
Medical Staff Services
Marietta, GA 30066-6340
Phone (770) 792-5451

Other practice location 1

216 Willis Ave
Suite 001
Roslyn Heights, NY 11577-2125
Phone (516) 801-0022

Other practice location 2

216 Willis Ave
Suite 001
Roslyn Heights, NY 11577-2125
Phone (516) 801-0022

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdolgoff286629@directwellstar.org

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
I20181107003646 GA Practitioner - Pediatric Medicine 7719231810 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80968GAMDPediatrics Physician
222857NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Oct 1, 2018 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Oct 1, 2018 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

51 Hiram Dr
Bldg B
Hiram, GA 30141
Phone (678) 945-8300

51 Hiram Dr
Ste B
Hiram, GA 30141
Phone (678) 945-8300

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

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

Interoperability endpoints

  • Direct secure messaging: jdolgoff286629@directwellstar.org

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1720065436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SANDY PLAINS ROAD",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666340",
            "telephone_number": "770-792-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 HIRAM DR BLDG B",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "30141",
            "telephone_number": "678-945-8300",
            "fax_number": "770-445-2060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 Willis Ave",
            "address_2": "Suite 001",
            "address_purpose": "LOCATION",
            "city": "Roslyn Heights",
            "state": "NY",
            "postal_code": "115772125",
            "country_code": "US",
            "telephone_number": "516-801-0022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "216 Willis Ave",
            "address_2": "Suite 001",
            "address_purpose": "LOCATION",
            "city": "Roslyn Heights",
            "state": "NY",
            "postal_code": "115772125",
            "country_code": "US",
            "telephone_number": "516-801-0022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLGOFF",
        "first_name": "JOANNA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-23",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "222857",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "80968",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdolgoff286629@directwellstar.org",
            "affiliation": "N",
            "address_1": "51 Hiram Dr Bldg B",
            "city": "Hiram",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301411844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

Verify at the official NPI Registry.