Individual provider Active NPI

Emma Atherton-Staples, D.O.

  • Family Medicine Physician
  • Kennesaw, GA
National Provider Identifier
1780063339
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
077229 Issued in GA
Practice address
5150 Stilesboro Rd NW Ste 120
Kennesaw, GA 30152-7741
Phone
(678) 354-0230
Fax
(678) 354-0828
NPI assigned
May 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 077229 GA Primary

Addresses

Primary practice location

5150 Stilesboro Rd NW Ste 120
Kennesaw, GA 30152-7741

Mailing address

5150 Stilesboro Rd NW Ste 120
Kennesaw, GA 30152-7741
Phone (678) 354-0230

Other practice location 1

1650 Chattahoochee Dr
Rockmart, GA 30153
Phone (770) 684-7846

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address eathertonstaples486173@directwellstar.org
Direct Messaging Address eathertonstaples486173@directwellstar.org Health Information Exchange (HIE)

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
I20170327001229 GA Practitioner - Family Practice 9133402118 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2015
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)

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jul 1, 2022 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Jul 1, 2022 Accepting new patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients
Floyd Physicians, LLC CurrentSince Jul 1, 2018 Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

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

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

304 Shorter Ave NW
Rome, GA 30165
Phone (706) 232-5650

420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

Interoperability endpoints

  • Direct secure messaging: eathertonstaples486173@directwellstar.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1780063339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 STILESBORO RD NW STE 120",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527741",
            "telephone_number": "678-354-0230",
            "fax_number": "678-354-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 STILESBORO RD NW STE 120",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527741",
            "telephone_number": "678-354-0230",
            "fax_number": "678-354-0828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Chattahoochee Dr",
            "address_purpose": "LOCATION",
            "city": "Rockmart",
            "state": "GA",
            "postal_code": "30153",
            "country_code": "US",
            "telephone_number": "770-684-7846",
            "fax_number": "770-684-8294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATHERTON-STAPLES",
        "first_name": "EMMA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "077229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eathertonstaples486173@directwellstar.org",
            "affiliation": "N",
            "address_1": "5150 Stilesboro Rd NW Ste 120",
            "city": "Kennesaw",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301527741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eathertonstaples486173@directwellstar.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5150 Stilesboro Rd NW Ste 120",
            "city": "Kennesaw",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301527741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.