NPIMap

Individual provider Active NPI

Phillip V Parry Sr., MD

  • Neurological Surgery Physician
  • Marietta, GA
National Provider Identifier
1770715559
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
79620 Issued in GA
Practice address
61 Whitcher St NE Ste 3110
Marietta, GA 30060
Phone
(770) 422-2326
Fax
(770) 422-7797
NPI assigned
Aug 13, 2009
Last updated
Oct 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT193737 PA
Neurological Surgery Physician 207T00000X A137553 CA
Neurological Surgery Physician 207T00000X 108344 MN
Neurological Surgery Physician 207T00000X 79620 GA Primary

Addresses

Primary practice location

61 Whitcher St NE Ste 3110
Marietta, GA 30060

Mailing address

61 Whitcher St NE Ste 3110
Marietta, GA 30060-1179
Phone (770) 422-2326

Other practice location 1

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone (707) 646-5000

Other practice location 2

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone (707) 646-5000

Other identifiers 1

IdentifierTypeStateIssuer
A137553OtherCACA LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pparry175507@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180918002641 GA Practitioner - Neurosurgery 6608181581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Tulane University School of Medicine, 2008
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)

61 Whitcher St
Suite 3110
Marietta, GA 30060-1176
Phone (770) 422-2326

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion106
Laminectomy or laminotomy (partial removal of spine bones)23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A137553CAMDNeurological Surgery Physician
79620GAMDNeurological Surgery Physician
MT193737PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jul 23, 2018 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Jul 23, 2018 Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients
Kennestone Hospital, Inc. Past Accepting new patients
Enloe Medical Center Past Accepting new patients

Locations

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

61 Whitcher St NE
Ste 3110
Marietta, GA 30060
Phone (770) 422-2326

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1770715559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE STE 3110",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601179",
            "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 ST NE STE 3110",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30060",
            "telephone_number": "770-422-2326",
            "fax_number": "770-422-7797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 B Gale Wilson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945333552",
            "country_code": "US",
            "telephone_number": "707-646-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 B Gale Wilson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945333552",
            "country_code": "US",
            "telephone_number": "707-646-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARRY",
        "first_name": "PHILLIP",
        "middle_name": "V",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-13",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT193737",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A137553",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MN",
            "license": "108344",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": "79620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE",
            "identifier": "A137553",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pparry175507@directwellstar.org",
            "affiliation": "N",
            "address_1": "61 Whitcher St NE Ste 3110",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.