NPIMap

Organization Active NPI

Wellstar Neurosurgery Services, LLC Dba Wellstar Neurosurgery

  • Neurological Surgery Physician
  • Marietta, GA
National Provider Identifier
1760798458
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
059122 Issued in GA
Legal business name
WELLSTAR NEUROSURGERY SERVICES, LLC DBA WELLSTAR NEUROSURGERY
Practice address
61 Whitcher Street
Suite 3110
Marietta, GA 30060
Phone
(770) 422-2326
Fax
(770) 422-7797
NPI assigned
Aug 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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

Authorized official

Name
Pam Roper
Title
Managed Care Representative
Phone
(770) 792-5276

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 059122 GA Primary

Addresses

Primary practice location

61 Whitcher Street
Suite 3110
Marietta, GA 30060

Mailing address

61 Whitcher Street
Suite 3110
Marietta, GA 30060
Phone (770) 422-2326

National Provider Directory

National Provider Directory
Tax ID family
Wellstar Medical Group LLC125 organizations share this tax ID, including this one

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

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322006400000",
    "number": "1760798458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 WHITCHER STREET",
            "address_2": "SUITE 3110",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30060",
            "telephone_number": "770-422-2326",
            "fax_number": "770-422-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 WHITCHER STREET",
            "address_2": "SUITE 3110",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30060",
            "telephone_number": "770-422-2326",
            "fax_number": "770-422-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR NEUROSURGERY SERVICES, LLC DBA WELLSTAR NEUROSURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-19",
        "last_updated": "2011-11-23",
        "status": "A",
        "authorized_official_last_name": "ROPER",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "MANAGED CARE REPRESENTATIVE",
        "authorized_official_telephone_number": "770-792-5276"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": "059122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.